Tyler, Jackson Wallace

Tyler, Jackson Wallace is an individual health care provider with primary practice located at 445 Savannah Hwy , Charleston SC 29407. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Tyler, Jackson Wallace can be contacted via phone (843) 766-2121.

Contact Information

Primary practice address
445 Savannah Hwy Charleston SC 29407
Phone: (843) 766-2121
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 8153 South Carolina
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PTL.0018085 Colorado

Profile Details

NPI number 1518411818
LBN Legal business name Tyler, Jackson Wallace
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2016
Last updated Jan 6th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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