Martin, Tyler
Martin, Tyler is an individual health care provider with primary practice located at 900 Wood Rd , Kenosha WI 53144-1133. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Martin, Tyler can be contacted via phone (262) 595-2164.Contact Information
Primary practice address
900 Wood Rd
Kenosha WI 53144-1133
Phone: (262) 595-2164
Fax: (262) 595-2225
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 1310-39 | Wisconsin |
Profile Details
| NPI number | 1043600919 |
|---|---|
| LBN Legal business name | Martin, Tyler |
| Credentials | MA, ATC, LAT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2015 |
| Last updated | Jan 30th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043600919 | NPPES |
| Wisconsin | Other | 2000003066 | NATABOC |
| Wisconsin | Other | 1310-39 | NATABOC |
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