Provider Demographics
NPI:1932279130
Name:TYLER, GEORGE WESLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WESLEY
Last Name:TYLER
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:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-0061
Mailing Address - Country:US
Mailing Address - Phone:919-815-3519
Mailing Address - Fax:
Practice Address - Street 1:3030 WAKE FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7844
Practice Address - Country:US
Practice Address - Phone:919-873-2525
Practice Address - Fax:919-873-2220
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor