MEDICARE: DR. TYLER LYNN DICKENSON D.C.

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	2301010328	MI

General Provider Information

NPI Number	:	1518322825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TYLER LYNN DICKENSON D.C.

Provider Business Mailing Address
First Line	:	1004 N US HIGHWAY 27
Second Line	:
City	:	SAINT JOHNS
State	:	MI
Zip	:	48879-1129
Country	:	US
Telephone Number	:	989-224-8228
Fax Number	:

Provider Business Practice Location Address
First Line	:	1004 N US HIGHWAY 27
Second Line	:
City	:	SAINT JOHNS
State	:	MI
Zip	:	48879-1129
Country	:	US
Telephone Number	:	989-224-8228
Fax Number	:

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

Provider Enumeration Date	:	12/31/2015
Last Update Date	:	12/31/2015

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Directions to “ DR. TYLER LYNN DICKENSON D.C.” Practice Location

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