Most Relevant Information
Provider Data
| NPI Number: | 1003321274 |
| Provider Name: | TYLER MARTIN RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/08/2017 |
| Last Updated: | 12/08/2017 |
Provider Practice Location
3568 GERAGHTY AVE
FAIRBANKS
AK
997094701
Practice Location Phone/Fax
| Phone: | 9073747001 |
| Fax: | 9073747008 |
Provider Mailing Location
3568 GERAGHTY AVE
FAIRBANKS
AK
997094701
Provider Mailing Phone/Fax
| Phone: | 9073747001 |
| Fax: | 9073747008 |