Provider Demographics
NPI:1992124036
Name:TYLER, CORINNE (PT)
Entity type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:
Last Name:TYLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6534 E COSTILLA PL
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1004
Mailing Address - Country:US
Mailing Address - Phone:303-770-7822
Mailing Address - Fax:
Practice Address - Street 1:10001 S OSWEGO ST
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3786
Practice Address - Country:US
Practice Address - Phone:303-988-2846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist