Poulson, Tyler Steven
Poulson, Tyler Steven is an sole proprietor health care provider with primary practice located at 21260 North 1450 East , Moroni UT 84646. He recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as his primary health care specialty. Poulson, Tyler Steven can be contacted via phone (435) 445-5200.Contact Information
Primary practice address
21260 North 1450 East
Moroni UT 84646
Phone: (435) 445-5200
Fax: (435) 445-5201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Substance Abuse Rehabilitation Facility | 324500000X | Utah |
Profile Details
| NPI number | 1902163678 |
|---|---|
| LBN Legal business name | Poulson, Tyler Steven |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 18th, 2012 |
| Last updated | Apr 18th, 2012 - about 12 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 | 1902163678 | NPPES |
| Utah | MEDICAID | 272503815 |
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