Individual
TYLER MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9000 TIMBERLYN WAY, FORT SMITH, AR 72903-7042
(479) 462-8589
Mailing address
9000 TIMBERLYN WAY, FORT SMITH, AR 72903-7042
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT2015-025
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-4914775
—
AR
Enumeration date
08/31/2015
Last updated
08/31/2015
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