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General NPI Number Information
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NPI Number | 1326899360
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Entity Type | Individual
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Provider Name | TYLER PARSONS LMT
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Gender | Male
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 424 WASHINGTON ST W
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City | CHARLESTON
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State | WV
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Zip | 25302-2131
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Country | US
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Telephone | 304-993-8998
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Fax |
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Provider Business Mailing Address
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Address Line | 5404 KENTUCKY ST APT 1
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25309-1048
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Country | US
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Telephone | 304-993-8998
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2011-2860
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License Number State | WV
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