Tyra, Teresa
Tyra, Teresa is an individual health care provider with primary practice located at 740 E Laurel Rd , London KY 40741-8601. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Tyra, Teresa can be contacted via phone (606) 877-3950.Contact Information
Primary practice address
740 E Laurel Rd
London KY 40741-8601
Phone: (606) 877-3950
Fax: (606) 877-3956
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | A00638 | Kentucky |
Profile Details
| NPI number | 1891991204 |
|---|---|
| LBN Legal business name | Tyra, Teresa |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1891991204 | NPPES |
| Kentucky | Other | A00638 | STATE LICENSE |
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