Individual
TYLER MARK RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
236 2ND AVE, LONG BRANCH, NJ 07740-6630
(732) 229-1649
(732) 229-5176
Mailing address
421 RIVER RD, FAIR HAVEN, NJ 07704-3029
(732) 758-9210
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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