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General NPI Number Information
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NPI Number | 1073925202
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Entity Type | Individual
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Provider Name | DEB TYLER
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Gender | Female
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Dates
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Enumeration Date | 05/22/2014
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Last Update Date | 05/22/2014
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Provider Practice Location Address
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Address Line | 85 BULLARD PASTURE RD
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City | WENDELL
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State | MA
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Zip | 01379-9705
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Country | US
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Telephone | 802-377-0825
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Fax |
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Provider Business Mailing Address
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Address Line | 85 BULLARD PASTURE ROAD
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City | WENDELL
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State | MA
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Zip | 01379
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Country | US
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Telephone | 802-377-0825
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 091.0086519
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License Number State | VT
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