MEDICARE: PHILIP TYLER TARRANT DPT

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	PT03215	RI
2	225100000X	Physical Therapist	10960	SC
3	225100000X	Physical Therapist	PT42558	FL

General Provider Information

NPI Number	:	1114574670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP TYLER TARRANT DPT

Provider Business Mailing Address
First Line	:	141 ATRIUM WAY
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-6301
Country	:	US
Telephone Number	:	803-957-0404
Fax Number	:	803-957-0468

Provider Business Practice Location Address
First Line	:	1787 S LAKE DR STE H
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29073-6736
Country	:	US
Telephone Number	:	803-957-0404
Fax Number	:

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

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	03/13/2025

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