Provider Demographics
NPI:1942066360
Name:GARCIA, TYLYNN ASHLEY (DPT)
Entity Type:Individual
Prefix:
First Name:TYLYNN
Middle Name:ASHLEY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 W HELENA AVE
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-2015
Mailing Address - Country:US
Mailing Address - Phone:509-899-1514
Mailing Address - Fax:
Practice Address - Street 1:502 E PIKES PEAK AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3611
Practice Address - Country:US
Practice Address - Phone:719-473-2958
Practice Address - Fax:719-473-1004
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0019689225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist