Most Relevant Information
Provider Data
| NPI Number: | 1003688300 |
| Provider Name: | TYLER PAUL MASON MOTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 4614 |
Most Important Dates
| Enumeration Date: | 10/30/2023 |
| Last Updated: | 10/30/2023 |
Provider Practice Location
3830 COMMONS AVE NE
ALBUQUERQUE
NM
871095831
Practice Location Phone/Fax
| Phone: | 5025424123 |
| Fax: |
Provider Mailing Location
PO BOX 33286
SANTA FE
NM
875943286
Provider Mailing Phone/Fax
| Phone: | 5054241239 |
| Fax: |