Provider Demographics
NPI:1790220853
Name:TREDWAY, EYONNA
Entity Type:Individual
Prefix:MRS
First Name:EYONNA
Middle Name:
Last Name:TREDWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43630 REVERE DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-1671
Mailing Address - Country:US
Mailing Address - Phone:313-347-3833
Mailing Address - Fax:
Practice Address - Street 1:43630 REVERE DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-1671
Practice Address - Country:US
Practice Address - Phone:313-347-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other