MEDICARE: DR. TYLER ROBERT PHILLIPS DC

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
1	111N00000X	Chiropractor	DC011922	PA

General Provider Information

NPI Number	:	1184470247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TYLER ROBERT PHILLIPS DC

Provider Business Mailing Address
First Line	:	2746 W COLLEGE AVE # B175
Second Line	:
City	:	STATE COLLEGE
State	:	PA
Zip	:	16801-4721
Country	:	US
Telephone Number	:	814-500-8504
Fax Number	:

Provider Business Practice Location Address
First Line	:	2746 W COLLEGE AVE # B175
Second Line	:
City	:	STATE COLLEGE
State	:	PA
Zip	:	16801-4721
Country	:	US
Telephone Number	:	814-500-8504
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2024
Last Update Date	:	04/15/2026

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