Individual
MRS. TYKECHIA TODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3644 CASEYS COVE, ELLENWOOD, GA 30294
(404) 604-4124
Mailing address
3644 CASEYS COVE, ELLENWOOD, GA 30294
(404) 604-4124
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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