Individual
RICKY TIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 SOUTH 19TH STREET (05-JA), BIRMINGHAM, AL 35233
(205) 933-8101
Mailing address
5201 9TH AVE S, GREAT FALLS, MT 59405-5711
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-063720
AL
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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