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Individual

TYISHA CHARLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPT, CNA

Contact information

Practice address
2290 W OREGON AVE # 1141, PHILADELPHIA, PA 19145-4197
(267) 971-0372
Mailing address
2290 W OREGON AVE # 1141, PHILADELPHIA, PA 19145-4197
(520) 729-2707
(445) 800-8643

Taxonomy

Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
A6S6G2H2
PA

Other

Enumeration date
06/20/2024
Last updated
12/11/2024
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