Individual
MR. TIMOTHY D TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, TRS
Contact information
Practice address
VA MEDICAL CENTER, 1111 EAST END BLVD., WILKES-BARRE, PA 18711-0030
(570) 824-3521
(570) 819-5143
Mailing address
17 COLONY DR, MOUNTAIN TOP, PA 18707-2218
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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