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Individual

KENNETH TYRE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
272 HOSPITAL RD, CHILLICOTHE, OH 45601-9031
(513) 672-4128
(513) 672-4479
Mailing address
200 NORTHLAND BLVD FL 1, CINCINNATI, OH 45246-3604
(513) 672-4128
(513) 672-4479

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA08721
OH
367500000X
Certified Registered Nurse Anesthetist
RN156286
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2641510
OH
Enumeration date
09/20/2006
Last updated
01/29/2024
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