Individual
TIFFANNY PITTS BLYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1026 MAIN ST, LEXINGTON, MO 64067-1345
(660) 259-2216
Mailing address
1026 MAIN ST, LEXINGTON, MO 64067-1345
(660) 259-2216
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2014012501
MO
Other
Enumeration date
06/29/2011
Last updated
10/27/2014
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