Individual
JAMIE R ANTWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-8978
Mailing address
1000 S BECKHAM AVE, TYLER, TX 75701-1908
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT81189
TX
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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