Individual
HOLLY TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 S LIMESTONE, LEXINGTON, KY 40508-3008
(859) 323-4756
Mailing address
509 N ARTHUR ASHE BLVD APT 6, RICHMOND, VA 23220-3339
(757) 710-7111
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0203019066
VA
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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