Tyler Martyn, | |
1627 4th St, Peru, IL 61354-3507 | |
(815) 223-4479 | |
(815) 223-4489 |
Full Name | Tyler Martyn |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 1627 4th St, Peru, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386406544 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | City Center Rehabilitation West - Inc. |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1396981742 PECOS PAC ID: 6901963164 Enrollment ID: O20090316000501 |
Mailing Address | Practice Location Address |
---|---|
Tyler Martyn, 2598 E 450th Rd, Oglesby, IL 61348-9715 Ph: (815) 252-2521 | Tyler Martyn, 1627 4th St, Peru, IL 61354-3507 Ph: (815) 223-4479 |
Christopher Shane Smith, Physical Therapist Medicare: Medicare Enrolled Practice Location: 1400 Midtown Road, Peru, IL 61354 Phone: 815-223-8600 Fax: 815-223-4667 | |
City Center Physical Therapy - Peru, Inc. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1627 4th St, Peru, IL 61354 Phone: 815-223-4479 Fax: 815-223-4489 | |
Gary Joseph Kistenfeger, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1400 Midtown Rd, Peru, IL 61354 Phone: 815-223-8600 | |
Luke Smith, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2011 Rock St, Suite E, Peru, IL 61354 Phone: 815-220-0058 Fax: 815-550-0082 | |
Moira Sibbaluca, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4231 Progress Blvd, Peru, IL 61354 Phone: 815-326-5924 | |
Mr. Spalding L Slevin Iv, PT, CMPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1424 Midtown Rd, Peru, IL 61354 Phone: 815-538-1354 Fax: 815-538-1361 | |
Dr. Kory David Tieman, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1627 4th St, Peru, IL 61354 Phone: 815-223-4479 |