Individual
VICTORIA TYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 S CEDAR ST, TAHLEQUAH, OK 74464-5152
(918) 478-2474
(918) 478-3079
Mailing address
601 S CEDAR ST, TAHLEQUAH, OK 74464-5152
(918) 478-2474
(918) 478-3079
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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