Individual
JOSHUA LAWRENCE TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12275 16TH ST APT C, YUCAIPA, CA 92399-1773
(909) 252-0955
Mailing address
12275 16TH ST APT C, YUCAIPA, CA 92399-1773
(909) 252-0955
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
275876
CA
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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