Healthcare Provider Details

I. General information

NPI: 1881648632
Provider Name (Legal Business Name): TYLER W. MCCLIMON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3346 MAIN ST
BIRDSBORO PA
19508-8136
US

IV. Provider business mailing address

272 LEVENGOOD RD
DOUGLASSVILLE PA
19518-9210
US

V. Phone/Fax

Practice location:
  • Phone: 610-582-4400
  • Fax:
Mailing address:
  • Phone: 610-689-0249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC008999
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: