Demetria Lavonna Tryon

NPI #1447533369 in Prague, Oklahoma

Provider Information

NPI Number: 1447533369
Entity Type: Individual
Name: Demetria Lavonna Tryon
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Enumeration Date: Sep 27, 2011
Last Updated: Sep 27, 2011

Practice Location

Address: 57533 MOCCASIN TRAIL RD
City: Prague
State: Oklahoma
ZIP Code: 74864-1143
Phone: (405) 567-0054

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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