Doctor Name: | MR. KENNETH D TYLER |
NPI Number: | 1720498066 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 33370 61st Road Arkansas City, KS - 67005 |
Business Phone Number: | 6204429645 |
Business Fax Number: | |
Mailing Address: | 33370 61st Road, ARKANSAS CITY |
State: | KS |
Postal Code: | 67005 |
Phone Number: | 6204429645 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2014 |
NPI Last Update Date: | 05/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |