Provider Demographics
NPI:1891324596
Name:DOMBROWSKI, TYLER WILLIAM (DC)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:WILLIAM
Last Name:DOMBROWSKI
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 1:450 WINDMERE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7646
Mailing Address - Country:US
Mailing Address - Phone:814-954-5095
Mailing Address - Fax:814-308-8369
Practice Address - Street 1:450 WINDMERE DR STE 250
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7646
Practice Address - Country:US
Practice Address - Phone:814-954-5095
Practice Address - Fax:814-308-8369
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor