Individual
JONATHAN CHRISTOPHER TYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 562-3000
Mailing address
1416 CRAZY HORSE LN APT 202, LOUISVILLE, KY 40243-3907
(216) 346-3341
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/08/2022
Last updated
04/08/2022
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