| Tyrie Llc | |
|
9881 Broken Land Pkwy Ste 105 Columbia MD 21046-3015 | |
| (443) 310-0689 | |
| Not Available |
| Full Name | Tyrie Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9881 Broken Land Pkwy Ste 105, Columbia, Maryland |
| Authorized Official Name and Position | Terrie Walts Tyrie (OWNER) |
| Authorized Official Contact | 4433100689 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tyrie Llc 11328 Liberty St Fulton MD 20759-2509 Ph: (443) 310-0689 | Tyrie Llc 9881 Broken Land Pkwy Ste 105 Columbia MD 21046-3015 Ph: (443) 310-0689 |
| NPI Number | 1790320109 |
|---|---|
| Provider Enumeration Date | 11/08/2019 |
| Last Update Date | 11/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790320109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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