Provider Demographics
NPI:1194121087
Name:PATTERSON, TYRE ARTENCIA (DPT)
Entity type:Individual
Prefix:
First Name:TYRE
Middle Name:ARTENCIA
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4065 N HAVERHILL RD STE B4
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-7439
Mailing Address - Country:US
Mailing Address - Phone:561-563-4458
Mailing Address - Fax:
Practice Address - Street 1:4065 N HAVERHILL RD STE B4
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-7439
Practice Address - Country:US
Practice Address - Phone:301-676-4511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105248600Medicaid