Healthcare Provider Details

I. General information

NPI: 1659231629
Provider Name (Legal Business Name): TYLER GODSEY DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 LITTLE YORK RD STE 10
DAYTON OH
45414-5803
US

IV. Provider business mailing address

6551 CENTERVILLE BUSINESS PKWY STE 120
CENTERVILLE OH
45459-2696
US

V. Phone/Fax

Practice location:
  • Phone: 937-415-9100
  • Fax: 937-415-9191
Mailing address:
  • Phone: 937-415-9100
  • Fax: 937-415-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT022133
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: