Individual
TAMMIE BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 W 4TH ST, COFFEYVILLE, KS 67337-3908
(620) 870-2816
Mailing address
1110 W 4TH ST, COFFEYVILLE, KS 67337-3908
(620) 870-2816
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
NONE
—
Enumeration date
08/03/2016
Last updated
08/03/2016
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