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Individual
TYLER BARTOLAZZI
Active
Individual
TYLER BARTOLAZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
5223
SC
363A00000X
Physician Assistant
Primary
5223
SC
Other
Enumeration date
12/21/2023
Last updated
05/29/2026
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