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Individual

AUNDREA RENEE TYNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
381 LAKEPORT BLVD, LAKEPORT, CA 95453-5412
(707) 263-5210
Mailing address
381 LAKEPORT BLVD, LAKEPORT, CA 95453-5412
(707) 263-5210

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT40130
CA

Other

Enumeration date
05/28/2013
Last updated
12/21/2015
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