Individual
TYLON TYRELL HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11714 SPRAGUE CIR, OMAHA, NE 68164-2253
(402) 516-5464
Mailing address
3317 N 107TH ST, OMAHA, NE 68134-3664
(402) 502-1035
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/22/2025
Last updated
02/22/2025
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