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Sandra Diane Tyree, IDC
Military Health Care Provider in Hahira, Georgia
NPI 1316298144

Sandra Diane Tyree is a Military Health Care Provider based in Hahira, GA. Sandra Diane Tyree practices in Hahira, GA and has the professional credentials of IDC. The NPI Number for Sandra Diane Tyree is 1316298144 and holds a License No. (Georgia).

The current practice location address for Sandra Diane Tyree is 6490 Clyattstone Rd, Hahira, GA and can be reached out via phone at 229-300-1226.

Location: 6490 Clyattstone Rd, Hahira, GA, 31632-3112
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316298144
Provider Name
Sandra Diane Tyree
Credential
IDC
Provider Entity Type
Individual
Gender
Female
Address
6490 Clyattstone Rd, Hahira, GA, 31632-3112
Phone Number
229-300-1226
Fax Number
Provider Enumeration Date
09/19/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6490 Clyattstone Rd
City
Hahira
State
Georgia
Zip
31632-3112
Phone Number
229-300-1226
Fax Number
person
Provider Business Mailing Address Details
Address
6490 Clyattstone Rd
City
Hahira
State
Georgia
Zip
31632-3112
Phone Number
229-300-1226
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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