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Contact Information

TYLER PERRY, PA-C, ATC
12846 3600 W
RIVERTON, UT84065
 Phone: 404-820-3570
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for TYLER PERRY · (Male)

NPI # 1730675851
Status Active
Credentials PA-C, ATC
Entity Individual
Enumeration date 07/02/2018
Last updated 05/05/2026 - About a month ago
Sole proprietor 1 No
Identifiers
  • UT License # 14176484-1206
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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