MEDICARE: TYLER A CENTNER PT

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	225100000X	Physical Therapist	LPT034598	AZ

General Provider Information

NPI Number	:	1104775998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER A CENTNER PT

Provider Business Mailing Address
First Line	:	2025 N CREEKSIDE DR
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-8311
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8996 W UNION HILLS DR STE 107
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-3010
Country	:	US
Telephone Number	:	602-361-0487
Fax Number	:

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

Provider Enumeration Date	:	01/24/2026
Last Update Date	:	01/24/2026

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Directions to “ TYLER A CENTNER PT” Practice Location

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