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General NPI Number Information
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NPI Number | 1114574670
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Entity Type | Individual
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Provider Name | PHILIP TYLER TARRANT DPT
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Gender | Male
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 1787 S LAKE DR STE H
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City | LEXINGTON
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State | SC
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Zip | 29073-6736
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Country | US
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Telephone | 803-957-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 141 ATRIUM WAY
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City | COLUMBIA
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State | SC
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Zip | 29223-6301
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Country | US
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Telephone | 803-957-0404
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Fax | 803-957-0468
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT03215
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10960
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT42558
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License Number State | FL
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