Doctor Name: | MR. TYLER SAVAGE |
NPI Number: | 1124429824 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 3333 Chemehuevi Blvd Lake Havasu City, AZ - 864067143 |
Business Phone Number: | 9288489878 |
Business Fax Number: | |
Mailing Address: | 3333 Chemehuevi Blvd, LAKE HAVASU CITY |
State: | AZ |
Postal Code: | 864067143 |
Phone Number: | 9288489878 |
Fax Number: | |
NPI Enumeration Date: | 09/12/2014 |
NPI Last Update Date: | 12/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246ZE0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | Electroneurodiagnostic |
Taxonomy Definition: |