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Individual

MISS MYLADY TIRADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.A

Contact information

Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-6588
(804) 675-5335
Mailing address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-6588
(804) 675-5335

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1710
PR

Other

Enumeration date
07/12/2012
Last updated
07/12/2012
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