Individual
TIMOTHY E. TYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
WAUKESHA MEMORIAL HOSPITAL-NEUROSCIENCE CENTER, 725 AMERICAN AVENUE, WAUKESHA, WI 53188
(262) 928-8200
(262) 928-8699
Mailing address
N17 W24100 RIVERWOOD DRIVE SUITE 250, PROHEALTH CARE MEDICAL ASSOCIATES INC, WAUKESHA, WI 53188-1177
(262) 928-4100
(262) 928-5835
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
508
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39065100
—
WI
Enumeration date
02/13/2006
Last updated
11/09/2011
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