Individual
TINA MARIE BYRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.PED, CMF.
Contact information
Practice address
397 S US HIGHWAY 231, JASPER, IN 47546-3299
(812) 482-6922
(812) 482-6923
Mailing address
397 S US HIGHWAY 231, JASPER, IN 47546-3299
(812) 482-6922
(812) 482-6923
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
C52837
IN
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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