Provider Demographics
NPI:1780309807
Name:RANGER, TYLER JAMES (BAA)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JAMES
Last Name:RANGER
Suffix:
Gender:M
Credentials:BAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4374 E COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:HALE
Mailing Address - State:MI
Mailing Address - Zip Code:48739-8822
Mailing Address - Country:US
Mailing Address - Phone:989-255-6930
Mailing Address - Fax:
Practice Address - Street 1:511 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9251
Practice Address - Country:US
Practice Address - Phone:989-345-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator