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1972298719
TY DANIEL LAUDERDALE
DALLAS, TX
NPI
1972298719
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-04-07
Last Update Date
2023-04-07
Business Address
TY DANIEL LAUDERDALE
3302 GASTON AVE
DALLAS, TX 75246-2013
Phone number: 214-828-8215
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Mailing Address
TY DANIEL LAUDERDALE
3302 GASTON AVE
DALLAS, TX 75246-2013
Phone number: 214-828-8215
Copy
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