Anderson, Tyra Louise
Anderson, Tyra Louise is an sole proprietor health care provider with primary practice located at 1514 Cleveland Ave Ste 103-5 , East Point GA 30344-6965. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Anderson, Tyra Louise can be contacted via phone (770) 256-7221.Contact Information
Primary practice address
1514 Cleveland Ave Ste 103-5
East Point GA 30344-6965
Phone: (770) 256-7221
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 1744P3200X | Georgia |
Profile Details
| NPI number | 1417448432 |
|---|---|
| LBN Legal business name | Anderson, Tyra Louise |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2018 |
| Last updated | Jun 16th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417448432 | NPPES |
| Georgia | Other | 825455207 | DEPARTMENT OF TREASURY INTERNAL REVENUE SERVICE |
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