| NPI | 1336106889 |
|---|---|
| Former Name | TYRA DOUGLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC23792) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 23792) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2019-04-30 |