Individual
MR. CHRISTOPHER COLGAN TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1190 E BROADWAY, LOUISVILLE, KY 40204-1712
(502) 627-0905
Mailing address
1190 E BROADWAY, LOUISVILLE, KY 40204-1712
(502) 627-0905
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3316
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3316
LICENSE
KY
Enumeration date
11/08/2007
Last updated
10/21/2016
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