Provider Demographics
NPI:1972969541
Name:WYBLE, LYN (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:LYN
Middle Name:
Last Name:WYBLE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 S SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-4491
Mailing Address - Country:US
Mailing Address - Phone:336-719-7129
Mailing Address - Fax:336-719-7396
Practice Address - Street 1:314 S SOUTH ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-4491
Practice Address - Country:US
Practice Address - Phone:336-719-7129
Practice Address - Fax:336-719-7396
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1579174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist