Provider Demographics
NPI:1437923455
Name:LESHER, TYLER MICHAEL (DHSC, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:MICHAEL
Last Name:LESHER
Suffix:
Gender:M
Credentials:DHSC, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 S SEPULVEDA BLVD UNIT 502
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4176
Mailing Address - Country:US
Mailing Address - Phone:307-259-1026
Mailing Address - Fax:
Practice Address - Street 1:2900 S SEPULVEDA BLVD UNIT 502
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-4176
Practice Address - Country:US
Practice Address - Phone:307-259-1026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty