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Individual

DR. DARRIN PHILLIP TYSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
11974 BALM RIVERVIEW RD, RIVERVIEW, FL 33569-6601
(813) 443-5223
Mailing address
920 W, LUMSDEN RD, BRANDON, FL 33511-6281
(813) 413-8465
(813) 413-8466

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH8966
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22086
BLUE CROSS BLUE SHEILDS
FL
01
AJ095
PTAN
FL
Enumeration date
09/20/2006
Last updated
03/27/2019
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