Individual
TYLER DORSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA, ATC
Contact information
Practice address
1611 QUARRIER ST APT A, CHARLESTON, WV 25311-2135
(304) 667-0715
Mailing address
181 HEATHERTON DR, LEWISBURG, WV 24901-9623
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002419
WV
251E00000X
Home Health Agency
002419
WV
Other
Enumeration date
10/11/2022
Last updated
11/29/2023
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