Individual
TYESIA ANDRETTE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPECIMEN COLLECTOR
Contact information
Practice address
153 N MILLER ST APT 47, HAZLEHURST, GA 31539-6818
(912) 347-2737
Mailing address
153 N MILLER ST APT 47, HAZLEHURST, GA 31539-6818
(912) 347-2737
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
GA
Other
Enumeration date
11/19/2021
Last updated
11/19/2021
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