Individual
MR. TY PRESTON AFFLECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 N DUTTON AVE, SANTA ROSA, CA 95401-4663
(707) 546-9400
(707) 546-9464
Mailing address
1255 N DUTTON AVE, SANTA ROSA, CA 95401-4663
(707) 546-9400
(707) 546-9464
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
G073843
CA
Other
Enumeration date
09/14/2006
Last updated
05/11/2009
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