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NPI Code Detail

MEDICARE: NANCY L TYLER PT

MEDICARE: NANCY L TYLER 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
1225100000XPhysical TherapistPT0000000184TN

General Provider Information

NPI Number : 1699868406
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY L TYLER PT
Provider Business Mailing Address
First Line : 3870 BOW ST NE
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-4801
Country : US
Telephone Number : 423-476-1467
Fax Number :
Provider Business Practice Location Address
First Line : 1204 FRYE ST
Second Line :
City : ATHENS
State : TN
Zip : 37303-3052
Country : US
Telephone Number : 423-745-0434
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/08/2007

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Directions to “ NANCY L TYLER PT” Practice Location

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