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TYLER JOHN BACK PA-C

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1144704867

Individual Registrant:
 TYLER JOHN BACK PA-C
Gender: M
Not Sole Proprietor

Location and contact information for practice:
3366 OAKDALE AVE N STE 303  ROBBINSDALE, MN 55422-2977 US
Tel: 763-520-7700  Fax: 763-520-7776

Contact information for business:
3366 OAKDALE AVE N STE 303  ROBBINSDALE, MN 55422-2977 US
Tel: 763-520-7700  Fax: 763-520-7776

Registration Information:
NPI: 1144704867
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS MN - Page 1

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