Individual
TYCHNIA RENEE MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
11761 US 70 BUSINESS HWY W STE 25, CLAYTON, NC 27520-2274
(919) 553-5600
(919) 553-6707
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2645
NC
Other
Enumeration date
03/23/2021
Last updated
01/04/2022
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