Individual
TYLER MANESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
35 SUGAR MAPLE LN, SAINT CHARLES, MO 63303-5740
(636) 946-8887
Mailing address
35 SUGAR MAPLE LN, SAINT CHARLES, MO 63303-5740
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2011032386
MO
Other
Enumeration date
10/29/2014
Last updated
10/29/2014
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