Provider Demographics
NPI:1508333741
Name:MCCARTHY, TYLER (PT,DPT,CSCS,CES,PES)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:PT,DPT,CSCS,CES,PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 VINCENT RD
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-6844
Mailing Address - Country:US
Mailing Address - Phone:774-306-6141
Mailing Address - Fax:
Practice Address - Street 1:48 EDDY ST UNIT 3
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2406
Practice Address - Country:US
Practice Address - Phone:508-313-9585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23977225100000X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist