Individual
MR. TYLOR JOHN SOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
1400 US HIGHWAY 61, FESTUS, MO 63028-4100
(636) 933-1680
Mailing address
1400 US HIGHWAY 61, FESTUS, MO 63028-4100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2022015922
MO
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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