Provider Demographics
NPI:1649922337
Name:WYNIA, CAITLYNN MARIANNE (ATC, LAT)
Entity type:Individual
Prefix:
First Name:CAITLYNN
Middle Name:MARIANNE
Last Name:WYNIA
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 DAVENTRY LN
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-4931
Mailing Address - Country:US
Mailing Address - Phone:605-786-4765
Mailing Address - Fax:
Practice Address - Street 1:75 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MONTEVALLO
Practice Address - State:AL
Practice Address - Zip Code:35115-3732
Practice Address - Country:US
Practice Address - Phone:205-665-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28002255A2300X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer