Individual
TYRA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44457 W KNAUSS DR, MARICOPA, AZ 85138-6430
(517) 414-6405
Mailing address
44457 W KNAUSS DR, MARICOPA, AZ 85138-6430
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-30249
AZ
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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