Provider Demographics
NPI:1346537594
Name:TRUMBO, TYLER BLESSING II (DPT)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:BLESSING
Last Name:TRUMBO
Suffix:II
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 N NELLIS BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5387
Mailing Address - Country:US
Mailing Address - Phone:573-576-7773
Mailing Address - Fax:
Practice Address - Street 1:4248 S NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-7607
Practice Address - Country:US
Practice Address - Phone:573-576-7773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV36812251X0800X
MO2011016194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic