Individual
TYRONE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 BRIGHTWATER DR, MYRTLE BEACH, SC 29579-8298
(843) 903-8958
Mailing address
117 BREAKERS DR UNIT 232, MYRTLE BEACH, SC 29579-4428
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2898
SC
Other
Enumeration date
01/29/2013
Last updated
01/29/2013
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