Individual
BRIAN TYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SPEECH THERAPIST
Contact information
Practice address
1168 CHULIO RD SE, ROME, GA 30161-4084
(706) 802-0990
Mailing address
309 ROSWELL AVE SE, ROME, GA 30161-6059
(706) 331-0213
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005445
GA
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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