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Individual

TYRA LARAE JONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
2120 LIVE STRONGER ST, TEA, SD 57064-8331
(605) 331-5890
Mailing address
2120 LIVE STRONGER ST, TEA, SD 57064-8331
(605) 331-5890

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0592
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01324319
DRIVERS LICENSE
SD
Enumeration date
05/23/2018
Last updated
07/03/2025
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