Provider Demographics
NPI:1427545789
Name:CURTIS, TYLER LEE (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:LEE
Last Name:CURTIS
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 REHOBOTH DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-8454
Mailing Address - Country:US
Mailing Address - Phone:501-827-2440
Mailing Address - Fax:
Practice Address - Street 1:1212 REHOBOTH DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-8454
Practice Address - Country:US
Practice Address - Phone:501-827-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-21
Last Update Date:2018-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6782255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer