MEDICARE: TYLER ASTON PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA.09064	OH

General Provider Information

NPI Number	:	1093103103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER ASTON PTA

Provider Business Mailing Address
First Line	:	230 HOWLAND WILSON RD SE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-2504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 HOWLAND WILSON RD SE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-2504
Country	:	US
Telephone Number	:	330-307-0601
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2014
Last Update Date	:	12/26/2014

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Directions to “ TYLER ASTON PTA” Practice Location

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