Individual
MS. TARLYN NICOLE WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
99 W 19TH ST, CHICAGO HEIGHTS, IL 60411-4002
(708) 754-3153
Mailing address
99 W 19TH ST, CHICAGO HEIGHTS, IL 60411-4002
(708) 754-3153
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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