Provider Demographics
NPI:1285378000
Name:NYGREN, TYLER D (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:D
Last Name:NYGREN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 MANUFACTURERS RD # C-113
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-3274
Mailing Address - Country:US
Mailing Address - Phone:423-803-6888
Mailing Address - Fax:
Practice Address - Street 1:313 MANUFACTURERS RD # C-113
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-3274
Practice Address - Country:US
Practice Address - Phone:423-803-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR011090111N00000X
TN3771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor