Individual
TYLER K CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-3076
Mailing address
4211 TROLLEY LINE RD, AIKEN, SC 29801-2749
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
TL30
SC
Other
Enumeration date
02/04/2013
Last updated
05/03/2021
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