Provider Demographics
NPI:1235616921
Name:TYLER, TRUDY DIONNE
Entity Type:Individual
Prefix:MS
First Name:TRUDY
Middle Name:DIONNE
Last Name:TYLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8871 RIVER MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7707
Mailing Address - Country:US
Mailing Address - Phone:901-756-4125
Mailing Address - Fax:
Practice Address - Street 1:493 DR ML KING JR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38126-2548
Practice Address - Country:US
Practice Address - Phone:901-526-0802
Practice Address - Fax:901-525-4483
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist