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Individual
TYLER MARK RICHARDS
Active
Individual
TYLER MARK RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00557700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6462620001
PTAN
NJ
05
—
8286108
—
NJ
Enumeration date
01/03/2007
Last updated
12/20/2010
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