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NPI Code Detail

MEDICARE: TYLER STUART VOAS

MEDICARE:   TYLER STUART VOAS
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1205294832
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER STUART VOAS
Provider Business Mailing Address
First Line : 1650 RIDGE ROCK CT
Second Line :
City : CHULA VISTA
State : CA
Zip : 91913-1773
Country : US
Telephone Number : 619-708-8572
Fax Number :
Provider Business Practice Location Address
First Line : 1650 RIDGE ROCK CT
Second Line :
City : CHULA VISTA
State : CA
Zip : 91913-1773
Country : US
Telephone Number : 619-708-8572
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2016
Last Update Date : 02/10/2016

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Directions to “ TYLER STUART VOAS ” Practice Location

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