Provider Demographics
NPI:1174335343
Name:ARVISO, TYLER-BROOKS (DC)
Entity type:Individual
Prefix:
First Name:TYLER-BROOKS
Middle Name:
Last Name:ARVISO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 DIAMOND CIR
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-4900
Mailing Address - Country:US
Mailing Address - Phone:505-879-2449
Mailing Address - Fax:
Practice Address - Street 1:208 E NIZHONI BLVD
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5744
Practice Address - Country:US
Practice Address - Phone:505-722-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDC-2025-0002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor