Healthcare Provider Details

I. General information

NPI: 1548495310
Provider Name (Legal Business Name): TYLER DEAN SMITH DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2009
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 N 2260 W
HURRICANE UT
84737-2034
US

IV. Provider business mailing address

PO BOX 25537
SALT LAKE CITY UT
84125-0537
US

V. Phone/Fax

Practice location:
  • Phone: 435-635-6480
  • Fax:
Mailing address:
  • Phone: 435-635-6489
  • Fax: 435-635-6499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7275316-2401
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number8542
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: