Provider Demographics
NPI:1225392376
Name:PERRY, TYLER N (PT)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:N
Last Name:PERRY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 E MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2123
Mailing Address - Country:US
Mailing Address - Phone:435-251-1000
Mailing Address - Fax:435-635-6499
Practice Address - Street 1:75 N 2260 W
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-2034
Practice Address - Country:US
Practice Address - Phone:435-635-6480
Practice Address - Fax:435-635-6499
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8223947-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist