Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 13179 | TX |
NPI | 1427407741 |
---|---|
Provider Name | Todd Tyo JR. |
First Address | Fort Worth, TX 76111-6613 |
Second Address | Fort Worth, TX 76111-6613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2016 |
Last Update Date | 07/06/2016 |