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NPI Code Detail

MEDICARE: TYLER R STUTZ DPT

MEDICARE: TYLER R STUTZ DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist05010927AIN

General Provider Information

NPI Number : 1134489180
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER R STUTZ DPT
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number : 586-350-2644
Fax Number : 586-541-3735
Provider Business Practice Location Address
First Line : 8628 PURDUE RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1114
Country : US
Telephone Number : 317-677-0660
Fax Number : 317-677-0640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2012
Last Update Date : 03/14/2024

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Directions to “ TYLER R STUTZ DPT” Practice Location

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