Provider Demographics
NPI:1487992624
Name:TYLER, JOHN MARK (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARK
Last Name:TYLER
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:210 COMMERCE WAY
Mailing Address - Street 2:STE 120
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-8200
Mailing Address - Country:US
Mailing Address - Phone:603-427-8066
Mailing Address - Fax:603-501-0495
Practice Address - Street 1:6071 HIGHWAY 54 LOWR LEVEL1
Practice Address - Street 2:
Practice Address - City:PHILPOT
Practice Address - State:KY
Practice Address - Zip Code:42366-9642
Practice Address - Country:US
Practice Address - Phone:270-713-3276
Practice Address - Fax:270-246-9719
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2024-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY5377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor