Doctor Name: | AUNDREA RENEE TYNER |
NPI Number: | 1164869400 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | PT40130 |
Business Practice Address: | 381 Lakeport Blvd Lakeport, CA - 954535412 |
Business Phone Number: | 7072635210 |
Business Fax Number: | |
Mailing Address: | 381 Lakeport Blvd, LAKEPORT |
State: | CA |
Postal Code: | 954535412 |
Phone Number: | 7072635210 |
Fax Number: | |
NPI Enumeration Date: | 05/28/2013 |
NPI Last Update Date: | 12/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT40130 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |