Individual
MR. WILLIAM TODD TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 E MAIN ST STE 202A, CANTON, GA 30114-2781
(678) 880-9128
(770) 213-3472
Mailing address
250 E MAIN ST STE 202A, CANTON, GA 30114-2781
(678) 880-9128
(770) 213-3472
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PHCP010396
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHCP010396
GEORGIA DEPARTMENT OF COMMUNITY HEALTH
GA
Enumeration date
06/22/2020
Last updated
06/22/2020
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