Individual
TYSON EARL HENSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
MCLB BARSTOW BLDG 17, BARSTOW, CA 92311-5008
(760) 577-6491
Mailing address
MCLB BARSTOW BLDG 17, BARSTOW, CA 92311-5008
(760) 577-6491
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
12/03/2007
Last updated
12/03/2007
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