Healthcare Provider Details

I. General information

NPI: 1740526292
Provider Name (Legal Business Name): TYLER LEE CRABTREE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2013
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 WASHINGTON ST STE 201
BRIGHTON MA
02135-2655
US

IV. Provider business mailing address

480 WASHINGTON ST STE 201
BRIGHTON MA
02135-2655
US

V. Phone/Fax

Practice location:
  • Phone: 617-739-0046
  • Fax: 617-738-9441
Mailing address:
  • Phone: 617-739-0046
  • Fax: 617-738-9441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3608
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: