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General NPI Number Information
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NPI Number | 1316888456
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Entity Type | Individual
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Provider Name | TYLER PROCTOR DC
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Gender | Male
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 11728 S 3600 W
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-5931
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Country | US
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Telephone | 801-871-0712
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Fax |
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Provider Business Mailing Address
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Address Line | 2826 S 2475 E
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-1828
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Country | US
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Telephone | 801-520-4118
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 11641006-1202
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License Number State | UT
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