Individual
TYLER ANDREW LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1890 SUMMIT BLVD # 240, PENSACOLA, FL 32503-3357
(850) 746-0600
Mailing address
24691 CHANTILLY LN, DAPHNE, AL 36526-6293
(662) 889-3980
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT21525
FL
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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