Provider Demographics
NPI:1972199438
Name:STYCHE, TYLER J (DC)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:J
Last Name:STYCHE
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 1:3975 DICK POND RD
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-6800
Mailing Address - Country:US
Mailing Address - Phone:843-650-3232
Mailing Address - Fax:
Practice Address - Street 1:3975 DICK POND RD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-6800
Practice Address - Country:US
Practice Address - Phone:843-650-3232
Practice Address - Fax:843-650-9877
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor