Provider Demographics
NPI:1538975149
Name:REMALEY, TYLAH (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:TYLAH
Middle Name:
Last Name:REMALEY
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 VALLEY AVE APT C
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1242
Mailing Address - Country:US
Mailing Address - Phone:419-494-8835
Mailing Address - Fax:
Practice Address - Street 1:608 13TH ST
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35228-2430
Practice Address - Country:US
Practice Address - Phone:659-273-3416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28252255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer