Provider Demographics
NPI:1942897467
Name:KAYE, TYLER (DC)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:KAYE
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 1:3218 SUBURBAN LN
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2250
Mailing Address - Country:US
Mailing Address - Phone:814-450-4440
Mailing Address - Fax:
Practice Address - Street 1:3218 SUBURBAN LN
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2250
Practice Address - Country:US
Practice Address - Phone:814-450-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-011722111N00000X
OHDC-05038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty