Most Relevant Information
Provider Data
| NPI Number: | 1003687153 |
| Provider Name: | MADISON G TYRUS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/09/2024 |
| Last Updated: | 01/09/2024 |
Provider Practice Location
3051 LUMBY DR APT 411
DECATUR
GA
300341894
Practice Location Phone/Fax
| Phone: | 9432065229 |
| Fax: |
Provider Mailing Location
3051 LUMBY DR APT 411
DECATUR
GA
300341894
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |