Provider Demographics
NPI:1003640756
Name:NOALL, TYLER JEFFREY (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:JEFFREY
Last Name:NOALL
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 1:245 N 700 W
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84318-4076
Mailing Address - Country:US
Mailing Address - Phone:435-563-4141
Mailing Address - Fax:
Practice Address - Street 1:245 N 700 W
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:UT
Practice Address - Zip Code:84318-4076
Practice Address - Country:US
Practice Address - Phone:435-563-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14152106-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor