Provider Demographics
NPI:1376757104
Name:T. J. TYLER, INC.
Entity Type:Organization
Organization Name:T. J. TYLER, INC.
Other - Org Name:CONCORDE KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:S
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:330-478-1752
Mailing Address - Street 1:5156 WHIPPLE AVENUE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2663
Mailing Address - Country:US
Mailing Address - Phone:330-478-1752
Mailing Address - Fax:330-478-1752
Practice Address - Street 1:5156 WHIPPLE AVENUE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2663
Practice Address - Country:US
Practice Address - Phone:330-478-1752
Practice Address - Fax:330-478-1763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QR0400X
261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation