Individual
MR. GREGORY ROSS TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5871 FRANK RD NW, NORTH CANTON, OH 44720-7543
(330) 497-6745
Mailing address
5871 FRANK RD NW, NORTH CANTON, OH 44720-7543
(330) 497-6745
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2710230
PROVIDER I.D. NUMBER
OH
Enumeration date
01/18/2008
Last updated
01/18/2008
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