Provider Demographics
NPI:1740526292
Name:CRABTREE, TYLER LEE (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:LEE
Last Name:CRABTREE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:480 WASHINGTON ST
Mailing Address - Street 2:STE 201
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2655
Mailing Address - Country:US
Mailing Address - Phone:617-739-0046
Mailing Address - Fax:617-738-9441
Practice Address - Street 1:2201 HENNEPIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-2738
Practice Address - Country:US
Practice Address - Phone:612-377-7760
Practice Address - Fax:612-374-3331
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3608111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor