Provider Demographics
NPI:1861778441
Name:SALZMAN, TYLER (PHARM D)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:SALZMAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-4000
Mailing Address - Country:US
Mailing Address - Phone:608-325-7020
Mailing Address - Fax:608-325-7026
Practice Address - Street 1:717 8TH AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-4000
Practice Address - Country:US
Practice Address - Phone:608-325-7020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist