Individual
SETH TYLER HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6122
Mailing address
PO BOX 277723, ATLANTA, GA 30384-7723
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
19265
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2416
—
SC
Enumeration date
01/21/2015
Last updated
04/17/2015
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