Healthcare Provider Details

I. General information

NPI: 1073405486
Provider Name (Legal Business Name): TYLER RIGBY BHCM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 S MAIN ST STE 6
TOOELE UT
84074-2136
US

IV. Provider business mailing address

60 S MAIN ST STE 6
TOOELE UT
84074-2136
US

V. Phone/Fax

Practice location:
  • Phone: 801-648-5351
  • Fax: 435-938-7151
Mailing address:
  • Phone: 801-648-5351
  • Fax: 435-938-7151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberF25-119957
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: