Most Relevant Information
Provider Data
| NPI Number: | 1003212168 |
| Provider Name: | TYLER PRUITT ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/17/2014 |
| Last Updated: | 11/17/2014 |
Provider Practice Location
499 VIKING DR
MOREHEAD
KY
403518320
Practice Location Phone/Fax
| Phone: | 6067848956 |
| Fax: |
Provider Mailing Location
499 VIKING DR
MOREHEAD
KY
403518320
Provider Mailing Phone/Fax
| Phone: | 6067848956 |
| Fax: |