Provider Demographics
NPI:1083241095
Name:TERRY, TYLER (DC)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:
Last Name:TERRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2839 35TH AVE UNIT C
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-9440
Mailing Address - Country:US
Mailing Address - Phone:970-616-8111
Mailing Address - Fax:970-616-8222
Practice Address - Street 1:2839 35TH AVE UNIT C
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-9440
Practice Address - Country:US
Practice Address - Phone:970-616-8111
Practice Address - Fax:970-616-8222
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor