Tyra Lyn Blackmon
Tyra Lyn Blackmon is an Other Technician in Detroit, Michigan. Registered with an NPI since 2021.
- In the registry since
- 2021
Practice location Address checks out
400 Renaissance Ctr Ste 2600Detroit, MI 48243-1502
Phone: (855) 832-6727
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Other Technician (primary) | Taxonomy 247200000X |
|---|
Record details
| NPI number | 1508440157 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | May 10, 2021 |
| Last updated in NPPES | May 13, 2021 |
| Certification date | May 13, 2021 |
| Mailing address | 9158 River Grove Rd, Flushing, MI 48433-8811 |
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