Individual
SCOTT JAMES TISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6624
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500637807
—
OR
01
—
P00995517
RR MEDICARE
OR
Enumeration date
08/09/2011
Last updated
11/04/2016
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