Individual
SANDRA DIANE TYREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
6490 CLYATTSTONE RD, HAHIRA, GA 31632-3112
(229) 300-1226
Mailing address
6490 CLYATTSTONE RD, HAHIRA, GA 31632-3112
(229) 300-1226
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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