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MRS. THERESA MONTGOMERY TYRIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
2021 N CROOKED BRANCH DR, LECANTO, FL 34461-9453
(352) 436-4428
Mailing address
2021 N CROOKED BRANCH DR, LECANTO, FL 34461-9453

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9293072
FL

Other

Enumeration date
09/07/2018
Last updated
09/07/2018
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