Individual
TYSON LEE LANGELIERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA -C, ATC, LAT
Contact information
Practice address
51600 HUNTINGTON RD, LA PINE, OR 97739
(541) 536-3435
Mailing address
PO BOX 3300, LA PINE, OR 97739-3300
(541) 536-3435
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT-223
ID
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/27/2006
Last updated
07/12/2018
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