Provider Demographics
NPI:1396094066
Name:HYATT, TANYA (PT)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:HYATT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 DOWNS LOOP
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-2035
Mailing Address - Country:US
Mailing Address - Phone:864-722-9059
Mailing Address - Fax:
Practice Address - Street 1:500 DOWNS LOOP
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-2035
Practice Address - Country:US
Practice Address - Phone:864-722-9059
Practice Address - Fax:610-925-7059
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist