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Individual

TYLER THOMAS HAWKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
3965 DORAL LN., ELKHART, IN 46517
(574) 221-9298
Mailing address
3965 DORAL LN, ELKHART, IN 46517-3867
(574) 221-9298

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003745A
IN

Other

Enumeration date
01/15/2010
Last updated
01/15/2010
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