Individual
TYLER BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
10014 N RODNEY PARHAM RD STE 103, LITTLE ROCK, AR 72227-5598
(501) 224-5454
(501) 224-5460
Mailing address
10014 N RODNEY PARHAM RD STE 103, LITTLE ROCK, AR 72227-5598
(501) 224-5454
(501) 224-5460
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
4481
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AR
Enumeration date
09/12/2018
Last updated
09/12/2018
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