Individual
TYLER JAMES MEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
451 E BISHOP FEDERAL LN, SALT LAKE CITY, UT 84115-2357
(801) 487-7557
Mailing address
451 E BISHOP FEDERAL LN, SALT LAKE CITY, UT 84115-2498
(801) 487-7557
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9705949-4201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9705949-4201
—
UT
Enumeration date
05/22/2018
Last updated
05/22/2018
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