Individual
TYLOR BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D
Contact information
Practice address
1850 W REPUBLIC RD, SPRINGFIELD, MO 65807-5730
(417) 891-4830
Mailing address
1850 W REPUBLIC RD, SPRINGFIELD, MO 65807-5730
(417) 891-4830
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
121552
IA
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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