Provider Demographics
NPI:1639449846
Name:EVANS, TYLER ALEXANDER (DC)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:ALEXANDER
Last Name:EVANS
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 1:875 GREENLAND RD UNIT A2
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4161
Mailing Address - Country:US
Mailing Address - Phone:603-380-9184
Mailing Address - Fax:033-809-1896
Practice Address - Street 1:875 GREENLAND RD UNIT A2
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4161
Practice Address - Country:US
Practice Address - Phone:603-380-9184
Practice Address - Fax:603-380-9184
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor