Provider Demographics
NPI:1891092979
Name:BEVINS, TYLER ANDREW (DPT)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:ANDREW
Last Name:BEVINS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MARION CT
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-9232
Mailing Address - Country:US
Mailing Address - Phone:423-741-2007
Mailing Address - Fax:
Practice Address - Street 1:5334 FORT HENRY DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-3729
Practice Address - Country:US
Practice Address - Phone:423-239-5774
Practice Address - Fax:423-239-5975
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT00000088572251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic