Provider Demographics
NPI:1902334345
Name:MAXEY, TYLER LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:LEE
Last Name:MAXEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 BOILING SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-6624
Mailing Address - Country:US
Mailing Address - Phone:864-678-0533
Mailing Address - Fax:864-752-6377
Practice Address - Street 1:2555 BOILING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316
Practice Address - Country:US
Practice Address - Phone:864-678-0533
Practice Address - Fax:864-752-6377
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4238111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor