Organization
TYBAR MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD SPIEGEL (PRESIDENT)
(636) 273-9913
Entity
Organization
Contact information
Practice address
2295 DOWNEY TERRACE DR, ELLISVILLE, MO 63011-1996
(636) 273-9913
(636) 273-9913
Mailing address
2295 DOWNEY TERRACE DR, ELLISVILLE, MO 63011-1996
(636) 273-9913
(636) 273-9913
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
LC0639198
MO
335E00000X
Prosthetic/Orthotic Supplier
LC0639198
MO
Other
Enumeration date
08/22/2009
Last updated
08/22/2009
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