Individual
MISTY DAWN TYSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
11610 MEMORIAL PKWY SW, HUNTSVILLE, AL 35803-2152
(256) 880-7261
Mailing address
129 BENNETT RD, EVA, AL 35621-8703
(256) 343-1731
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13855
AL
183500000X
Pharmacist
16148
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13855
ALABAMA BOARD OF PHARMACY
AL
Enumeration date
06/22/2017
Last updated
06/16/2018
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