Individual
TYLER WAYNE TUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 S WALDRON RD, FORT SMITH, AR 72903-2574
(479) 226-3409
Mailing address
28345 OLD TARBY RD, POTEAU, OK 74953-7167
(918) 413-5113
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR3382
AR
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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