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1649670472
TYREE L REVANGE
TALLAHASSEE, FL
NPI
1649670472
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL PT29648)
Enumeration Date
2014-08-29
Last Update Date
2014-08-29
Business Address
-- TYREE L REVANGE
2410 W PLAZA DR
TALLAHASSEE, FL 32308-5325
Phone number: 850-285-6185
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Mailing Address
-- TYREE L REVANGE
1453 FISHER LN
TALLAHASSEE, FL 32301-4901
Phone number: 941-201-2316
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