Individual
MEISHELLE BOST TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
82 JK POWELL RD, WHITEVILLE, NC 28472-3115
(910) 499-2563
Mailing address
82 J.K. POWELL ROAD, WHITEVILLE, NC 28472
(910) 499-2563
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2970
NC
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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