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General NPI Number Information
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NPI Number | 1487541736
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Entity Type | Individual
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Provider Name | TYLER HEILAMAN
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Gender | Male
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 9401 N KELLEY AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73131-2441
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Country | US
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Telephone | 405-250-3071
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Fax |
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Provider Business Mailing Address
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Address Line | 9401 N KELLEY AVE STE B
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City | OKLAHOMA CITY
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State | OK
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Zip | 73131-2442
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Country | US
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Telephone | 405-250-3071
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2594
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License Number State | OK
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