Individual
JORDAN TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4200 EVEREST DR, GASTONIA, NC 28054-0004
(202) 558-8223
Mailing address
4200 EVEREST DR, GASTONIA, NC 28054-0004
(202) 558-8223
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/09/2026
Last updated
02/09/2026
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