Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 23977 | MA |
Y | 2251S0007X | Physical Therapist - Sports | 23977 | MA |
NPI | 1508333741 |
---|---|
Provider Name | Dr. Tyler Mccarthy |
First Address | Attleboro, MA 02703-6844 |
Second Address | Attleboro, MA 02703-2406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2018 |
Last Update Date | 30/08/2019 |