Individual
UNIQUE TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3854 PARK OVERLOOK DR, BEAVERCREEK, OH 45431-5801
(937) 429-9655
Mailing address
297 ORVILLE ST, FAIRBORN, OH 45324-6606
(567) 315-4060
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA013742
OH
Other
Enumeration date
07/06/2024
Last updated
07/06/2024
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