Individual
TYRA D WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10780 N PRESERVE WAY APT 103, MIRAMAR, FL 33025-6576
(786) 907-6598
Mailing address
10780 N PRESERVE WAY APT 103, MIRAMAR, FL 33025-6576
(786) 907-6598
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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