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General NPI Number Information
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NPI Number | 1487992624
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Entity Type | Individual
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Provider Name | JOHN MARK TYLER D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 6071 HIGHWAY 54 LOWR LEVEL1
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City | PHILPOT
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State | KY
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Zip | 42366-9642
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Country | US
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Telephone | 270-713-3276
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Fax | 270-246-9719
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Provider Business Mailing Address
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Address Line | 210 COMMERCE WAY STE 120
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City | PORTSMOUTH
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State | NH
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Zip | 03801-8200
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Country | US
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Telephone | 603-427-8066
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Fax | 603-501-0495
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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 | 5377
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License Number State | KY
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