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Individual

TYONI POUGH-BRYANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1135 FORTUNA ST, PERRIS, CA 92571-7709
(909) 294-4538
Mailing address
1135 FORTUNA ST, PERRIS, CA 92571-7709
(909) 294-4538

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Enumeration date
10/22/2021
Last updated
10/22/2021
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