Provider Demographics
NPI:1831697291
Name:ESSER, TYLER JAMES (PT, DPT)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JAMES
Last Name:ESSER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1969 WEST HART RD
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-2283
Mailing Address - Country:US
Mailing Address - Phone:843-610-8099
Mailing Address - Fax:
Practice Address - Street 1:1969 WEST HART RD
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-2283
Practice Address - Country:US
Practice Address - Phone:608-364-5689
Practice Address - Fax:608-364-5452
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070025786225100000X
MI5501018520225100000X
WI13798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist