Provider Demographics
NPI:1528331048
Name:TYLER K MILLER
Entity type:Organization
Organization Name:TYLER K MILLER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, RCP, RPSGT
Authorized Official - Phone:435-835-8220
Mailing Address - Street 1:242 N 300 E
Mailing Address - Street 2:
Mailing Address - City:MANTI
Mailing Address - State:UT
Mailing Address - Zip Code:84642-1107
Mailing Address - Country:US
Mailing Address - Phone:435-835-8220
Mailing Address - Fax:
Practice Address - Street 1:242 N 300 E
Practice Address - Street 2:
Practice Address - City:MANTI
Practice Address - State:UT
Practice Address - Zip Code:84642-1107
Practice Address - Country:US
Practice Address - Phone:435-835-8220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies