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Organization
THERAPEUTIC HEALTH CLINIC
Active
Organization
THERAPEUTIC HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BEN WESLEY TYSON (M)
(229) 386-2534
Entity
Organization
Contact information
Practice address
223 CENTRAL AVE N, TIFTON, GA 31794-4344
(229) 387-7111
(229) 387-7111
Mailing address
2111 FERRY LAKE RD, TIFTON, GA 31794-2961
(229) 386-2534
(229) 386-2534
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245292291
NPI
GA
01
—
1265734750
NPI
GA
Enumeration date
10/14/2014
Last updated
10/14/2014
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