Individual
MARK TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PARAMEDIC
Contact information
Practice address
1007 E HOSMER ST, LOVES PARK, IL 61111-4164
(815) 505-3246
Mailing address
1007 E HOSMER ST, LOVES PARK, IL 61111-4164
(815) 505-3246
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
060204401
IL
Other
Enumeration date
03/17/2016
Last updated
05/19/2016
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