Basic Information
| Provider Information | |||||||||
| NPI: | 1164160842 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEYERS | ||||||||
| FirstName: | TYLER | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6160 TUTT BLVD STE 240 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809233502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195960880 | ||||||||
| FaxNumber: | 7195960899 | ||||||||
| Practice Location | |||||||||
| Address1: | 6160 TUTT BLVD STE 240 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809233502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195960880 | ||||||||
| FaxNumber: | 7195960899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2022 | ||||||||
| LastUpdateDate: | 05/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 18352 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.