| Doctor Name: | MR. CHARLES THOMAS TYNER |
| NPI Number: | 1043236714 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.P.T. |
| License Number: | LA4433 |
| Business Practice Address: | 301 W Airline Hwy Suite 104 La Place, LA - 700683823 |
| Business Phone Number: | 9856539242 |
| Business Fax Number: | 9856539324 |
| Mailing Address: | 7133 Edgewater Dr, MANDEVILLE |
| State: | LA |
| Postal Code: | 704717431 |
| Phone Number: | 9856539242 |
| Fax Number: | 9856539324 |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | LA4433 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | LA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |