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General NPI Number Information
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NPI Number | 1760788905
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Entity Type | Individual
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Provider Name | CHARLES WATSON TYLER D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2011
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 3011 S LINDSAY RD SUITE 101
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City | GILBERT
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State | AZ
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Zip | 85295-4332
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Country | US
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Telephone | 480-726-2500
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Fax | 480-726-2131
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Provider Business Mailing Address
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Address Line | 3011 S LINDSAY RD STE. 101
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City | GILBERT
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State | AZ
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Zip | 85295-4332
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Country | US
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Telephone | 480-726-2500
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Fax | 480-726-2131
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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 | 8248
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License Number State | AZ
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