Individual
MS. ANITRA RANEE TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
915 HAZEL ST, SOUTH HAVEN, MI 49090-1613
(269) 286-2725
Mailing address
915 HAZEL ST, SOUTH HAVEN, MI 49090-1613
(269) 286-2725
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/24/2022
Last updated
03/30/2022
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