Individual
TYLER HENNESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
810 CHEROKEE CT, PAOLA, KS 66071-2112
(913) 909-3459
Mailing address
810 CHEROKEE CT, PAOLA, KS 66071-2112
(913) 909-3459
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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