Individual
TYLER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTA/L
Contact information
Practice address
1011 PORTERS NECK RD., WILMINGTON, NC 28411
(910) 622-2279
Mailing address
68 COMBINE LN SE, LELAND, NC 28451-9650
(910) 622-2279
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11827
ND
Other
Enumeration date
05/13/2025
Last updated
05/13/2025
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