Individual
TYLER GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1025 SE TALLGRASS LANE STE 210, WAUKEE, IA 50263
(515) 875-9706
(515) 875-9707
Mailing address
PO BOX 424, DES MOINES, IA 50302-0424
(515) 875-9925
(515) 875-9923
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
091601
IA
225100000X
Physical Therapist
2016027260
MO
Other
Enumeration date
09/01/2016
Last updated
02/21/2024
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