Individual
MISS PATRICE IRVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
900 S BAXTER AVE, TYLER, TX 75701-2209
(903) 597-2805
Mailing address
3857 LOUISE CT, TYLER, TX 75709-5439
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2049953
TX
Other
Enumeration date
12/20/2014
Last updated
12/20/2014
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