Individual
TYRONE CHARLES ANDERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HEALTH SERVICES TECH
Contact information
Practice address
COMDT (CG-1122), U.S. COAST GUARD2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(860) 625-0830
(860) 439-1659
Mailing address
234 CYPRESS LAKES DR, SLIDELL, LA 70458-6244
(860) 625-0830
(860) 439-1659
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
01/04/2006
Last updated
07/08/2007
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