Tyus Temple
Student in an Organized Health Care Education/Training Program in Chicago, IL. Individual provider (NPI-1).
NPI number1083315212
StatusActive
Last updated in NPPESJun 18, 2024
Details
- NPI
- 1083315212
- Entity type
- Individual (NPI-1)
- Name
- Tyus Temple
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2023
- Certification date
- Jun 18, 2024
- Last updated
- Jun 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
5145 N California AveChicago, IL 60625-3661
Phone 773-989-3803
Mailing address
5145 N California AveChicago, IL 60625-3661
Phone 773-989-3803
Other practice locations
191 W Union St
Athens, OH 45701-2732
Athens, OH 45701-2732
Phone 740-593-2500
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