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Individual

LAURA EUGENA TYSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
501 N DAVIS ST, NASHVILLE, GA 31639-1426
(229) 316-8200
(229) 686-2687
Mailing address
501 N DAVIS ST, NASHVILLE, GA 31639-1426
(229) 316-8200
(229) 686-2687

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
016946
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016946
STATE PHARMACIST LICENSE
GA
Enumeration date
10/11/2006
Last updated
12/23/2020
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