Individual
TYLER BURCHAM
Active
Individual
TYLER BURCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PT2542
ID
225100000X
Physical Therapist
Primary
1738
ND
225100000X
Physical Therapist
PT-2542
ID
Other
Enumeration date
08/04/2009
Last updated
06/06/2013
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