Individual
TYLER JAMES GREGURICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 LOUISIANA BLVD NE STE 410, ALBUQUERQUE, NM 87110-5412
(505) 724-4300
Mailing address
9141 GRAND AVE, OMAHA, NE 68134-2723
(402) 980-2485
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2255A2300X
Athletic Trainer
—
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
NE
Other
Enumeration date
12/09/2019
Last updated
04/01/2024
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