Individual
TYLER RAYMOND WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
16 WOODBINE LANE, DANVILLE, PA 17822
(570) 214-9835
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
OS019333
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/03/2013
Last updated
08/19/2020
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