Provider Demographics
NPI:1811620040
Name:ALLBRITTON, TYLER J
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:J
Last Name:ALLBRITTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30245 GILL RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:LA
Mailing Address - Zip Code:70744-4911
Mailing Address - Country:US
Mailing Address - Phone:225-209-8289
Mailing Address - Fax:
Practice Address - Street 1:500 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-1304
Practice Address - Country:US
Practice Address - Phone:985-549-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer