Individual
TYLER TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
543 TAYLORSVILLE RD STE 101, TAYLORSVILLE, KY 40071-6766
(502) 477-6410
Mailing address
543 TAYLORSVILLE RD STE 101, TAYLORSVILLE, KY 40071-6766
(502) 477-6410
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006755
KY
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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