Russell M Tyler PHD, LP

NPI 1134287766 - Psychologist - 103TB0200X

NPI Details
NPI 1134287766
Gender Male
Enumeration Date 12/05/2006
Last Updated 07/09/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
115 1ST ST. N
BRAINERD MN, 56401, US
Phone (218) 828-6274
Fax (218) 828-4209
Business Location
723 S 5TH ST
BRAINERD MN, 56401-4018, US
Phone (218) 828-2948
Fax (218) 828-4209
Toxanomy
Taxonomy Code 103TB0200X
License State Minnesota
License Number LP0053
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According to our database, Russell M Tyler PHD, LP NPI is 1134287766, taxonomy code is 103TB0200X and license number is LP0053, license state is located at Minnesota. Russell M Tyler PHD, LP physically located at 115 1st St. N, Brainerd MN, 56401. NPI Number Russell M Tyler PHD, LP has the Individual type.

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1134287766 NPI number is provided on an as is basis without warranty of any kind. 1134287766 is maintained by the National Plan & Provider Enumeration System. The contents of Russell M Tyler PHD, LP are for informational purposes only.