Provider Demographics
NPI:1285153924
Name:FERRELL, TYLER JOHN (PT, DPT)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JOHN
Last Name:FERRELL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-8930
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:775 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-2166
Practice Address - Country:US
Practice Address - Phone:859-572-1689
Practice Address - Fax:859-441-0153
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12553225100000X
AZ13206225100000X
GAPT013939225100000X
OR63144225100000X
KS11-06378225100000X
KY008274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist