Provider Demographics
NPI:1487476776
Name:WINGFIELD, SKYLUAR (LMT)
Entity type:Individual
Prefix:
First Name:SKYLUAR
Middle Name:
Last Name:WINGFIELD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 TURNEY RD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2503
Mailing Address - Country:US
Mailing Address - Phone:216-429-9700
Mailing Address - Fax:
Practice Address - Street 1:5004 TURNEY RD
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2503
Practice Address - Country:US
Practice Address - Phone:216-429-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist