Individual
TYRA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5299 BUTTERNUT CT W, COLUMBUS, OH 43229-5211
(614) 735-0643
Mailing address
5299 BUTTERNUT CT W, COLUMBUS, OH 43229-5211
(614) 735-0643
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
323867170108
OH
Other
Enumeration date
08/20/2012
Last updated
08/20/2012
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