Provider Demographics
NPI:1043811847
Name:TYLER, WILLIAM BRIAN (RRT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRIAN
Last Name:TYLER
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12134 ELMONT RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7600
Mailing Address - Country:US
Mailing Address - Phone:804-868-9134
Mailing Address - Fax:
Practice Address - Street 1:12134 ELMONT RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7600
Practice Address - Country:US
Practice Address - Phone:804-868-9134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0117009026227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered