Individual
ALLEN TYLER NANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
6510 HIGHWAY 90 STE D, GAUTIER, MS 39553-5015
(228) 875-7259
(228) 438-2038
Mailing address
PO BOX 200880, DALLAS, TX 75320-0880
(678) 837-7176
(404) 777-1311
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00004730
TN
2251X0800X
Orthopedic Physical Therapist
00004730
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3652689
—
TN
Enumeration date
06/16/2005
Last updated
03/12/2025
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