Individual
MR. TYLER AMOS LASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LLC
Contact information
Practice address
800 E MILHAM AVE STE 200, PORTAGE, MI 49002-1492
(269) 249-7179
Mailing address
800 E MILHAM AVE STE 200, PORTAGE, MI 49002-1492
(269) 249-7179
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451023759
MI
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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