Tyler Gaudry, DC | |
333 N Dobson Rd Ste 16, Chandler, AZ 85224-4412 | |
(480) 899-9855 | |
Not Available |
Full Name | Tyler Gaudry |
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Gender | Male |
Speciality | Chiropractor |
Location | 333 N Dobson Rd Ste 16, Chandler, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366146581 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 8910 (Arizona) | Primary |
Provider Name | Chandler Chiropractic Clinic |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1588846984 PECOS PAC ID: 6800850868 Enrollment ID: O20041118000733 |
Mailing Address | Practice Location Address |
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Tyler Gaudry, DC 9823 E Kiva Ave, Mesa, AZ 85209-2441 Ph: () - | Tyler Gaudry, DC 333 N Dobson Rd Ste 16, Chandler, AZ 85224-4412 Ph: (480) 899-9855 |
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