Individual
TYLER SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
23655 NOVI RD STE 101, NOVI, MI 48375-5442
(248) 277-3440
(248) 277-3441
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502008732
MI
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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