Provider Demographics
NPI:1538730759
Name:MUSICK, TYLER (DPT)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:MUSICK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 ALFORD AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3100
Mailing Address - Country:US
Mailing Address - Phone:205-824-8850
Mailing Address - Fax:
Practice Address - Street 1:4955 MCADORY SCHOOL RD
Practice Address - Street 2:
Practice Address - City:MC CALLA
Practice Address - State:AL
Practice Address - Zip Code:35111-3483
Practice Address - Country:US
Practice Address - Phone:205-434-4813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist