Individual
JARED CHARLES TYHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1614 MAIN ST, LEBANON, VA 24266
(276) 889-1315
Mailing address
PO BOX 2020, LEBANON, VA 24266-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002655
VA
Other
Enumeration date
06/11/2018
Last updated
01/07/2025
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