Individual
KIRSTIE A TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ALC
Contact information
Practice address
2900 MCGEHEE RD, MONTGOMERY, AL 36111-2151
(334) 280-3349
(334) 356-1426
Mailing address
PO BOX 11087, MONTGOMERY, AL 36111-0087
(334) 280-3349
(334) 356-1426
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2799
ALC
AL
Enumeration date
06/04/2018
Last updated
06/04/2018
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