Individual
MRS. JERE NELL TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
82 ROAD 5151, BLOOMFIELD, NM 87413-9700
(505) 330-9884
Mailing address
82 ROAD 5151, BLOOMFIELD, NM 87413-9700
(505) 330-9884
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
254
NM
Other
Enumeration date
03/07/2010
Last updated
03/07/2010
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