Individual
SAMANTHA TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
2278 HIGHWAY 65 N, MARSHALL, AR 72650-7660
(870) 448-3894
(479) 967-2876
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A824
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201527721
—
AR
Enumeration date
12/23/2013
Last updated
01/13/2023
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