Individual
TYJUAN VIDAL TYLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2881 S VALLEY VIEW BLVD, LAS VEGAS, NV 89102-0100
(702) 253-9474
Mailing address
408 HOLLAND AVE, LAS VEGAS, NV 89106-2631
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
12/18/2018
Last updated
12/18/2018
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