| Tyqwisha Gwynn, OTL | |
|
2058 Spring Creek Dr, Durham, NC 27704-6110 | |
| (919) 667-5593 | |
| Not Available |
| Full Name | Tyqwisha Gwynn |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 2058 Spring Creek Dr, Durham, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346013794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 16393 (North Carolina) | Primary |
| Provider Name | Legacy Healthcare Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1104823400 PECOS PAC ID: 2163339722 Enrollment ID: O20170118000750 |
| Mailing Address | Practice Location Address |
|---|---|
| Tyqwisha Gwynn, OTL 110 Horizon Dr Ste 310, Raleigh, NC 27615-4926 Ph: () - | Tyqwisha Gwynn, OTL 2058 Spring Creek Dr, Durham, NC 27704-6110 Ph: (919) 667-5593 |
Robin Sheila Munsey, OTD, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 3000 Erwin Rd, Durham, NC 27705 Phone: 919-668-3988 | |
Robbin A. Newton, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: Dumc 3120, Durham, NC 27710 Phone: 919-684-2869 Fax: 919-681-7574 | |
Nancy N. Belding, LPT Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 120 William Penn Plz, Durham, NC 27704 Phone: 919-220-5255 Fax: 919-220-6971 | |
Mrs. Jenny Musselwhite Terry, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3015 Appling Way, Durham, NC 27703 Phone: 919-596-2120 | |
Adam Deprimo, MS, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3000 Erwin Rd, Durham, NC 27705 Phone: 919-684-5147 | |
Mary Hart Macleod, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3000 Erwin Rd, Durham, NC 27705 Phone: 919-668-7240 | |
Ashley Marie Gaudino, MOTR/L Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 4709 Creekstone Drive, Durham, NC 27703 Phone: 919-660-5049 |