Organization
TYRONE L CREW
Active
Other names
Mediation Of The Self
Organization subpart
No
Provider details
NPI number
Authorized official
TYRONE CREW (OWNER)
(701) 730-9365
Entity
Organization
Contact information
Practice address
4330 10TH AVE S APT 305, FARGO, ND 58103-7088
(701) 730-9365
Mailing address
4330 10TH AVE S APT 305, FARGO, ND 58103-7088
(701) 730-9365
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
12/05/2019
Last updated
02/04/2024
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