Provider Demographics
NPI:1457816373
Name:BARTON, TYLER ERNEST (DC)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:ERNEST
Last Name:BARTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4931 WISSAHICKON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4800
Mailing Address - Country:US
Mailing Address - Phone:215-842-2227
Mailing Address - Fax:
Practice Address - Street 1:4931 WISSAHICKON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4800
Practice Address - Country:US
Practice Address - Phone:215-842-2227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor