Provider Demographics
NPI:1023281193
Name:ROY, TYLER JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:JAMES
Last Name:ROY
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 1:45070 US HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:CHASSELL
Mailing Address - State:MI
Mailing Address - Zip Code:49916-9116
Mailing Address - Country:US
Mailing Address - Phone:906-482-2400
Mailing Address - Fax:906-482-3080
Practice Address - Street 1:45070 US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:CHASSELL
Practice Address - State:MI
Practice Address - Zip Code:49916-9116
Practice Address - Country:US
Practice Address - Phone:906-482-2400
Practice Address - Fax:906-482-3080
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITR009412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor