Provider Demographics
NPI:1851127880
Name:DIPALMA, TYLER
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:DIPALMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WADSWORTH FARM RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3229
Mailing Address - Country:US
Mailing Address - Phone:774-487-9377
Mailing Address - Fax:
Practice Address - Street 1:6 WADSWORTH FARM RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3229
Practice Address - Country:US
Practice Address - Phone:774-487-9377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3212692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer