Healthcare Provider Details

I. General information

NPI: 1326821000
Provider Name (Legal Business Name): TYLER NELSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3971 LITTLE SAVANNAH RD SUITE 113
CULLOWHEE NC
28723
US

IV. Provider business mailing address

PO BOX 2274
CULLOWHEE NC
28723-2274
US

V. Phone/Fax

Practice location:
  • Phone: 828-293-5174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: