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1245474667
DANIEL LEWIS TYSON
CLOVIS, NM
NPI
1245474667
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1003X Military Health Care Provider Independent Duty Medical Technicians
Enumeration Date
2009-04-29
Last Update Date
2009-04-29
Business Address
DANIEL LEWIS TYSON IDMT
208 W CASABLANCA AVE
CLOVIS, NM 88103-5009
Phone number: 575-784-7801
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Mailing Address
DANIEL LEWIS TYSON IDMT
208 W CASABLANCA AVE
CLOVIS, NM 88103-5009
Phone number: 575-784-7801
Copy
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