Tyler Steven Poulson
Tyler Steven Poulson is a Substance Abuse Rehabilitation Facility in Moroni, Utah. Practices as a sole proprietor. Licensed in Utah.
- Licensed in
- UT
- In the registry since
- 2012
Practice location Address checks out
21260 N 1450 EMoroni, UT 84646
Phone: (435) 445-5200
Fax: (435) 445-5201
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Specialties & licences
| Substance Abuse Rehabilitation Facility (primary) | Taxonomy 324500000X (UT) |
|---|
Record details
| NPI number | 1902163678 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 18, 2012 |
| Last updated in NPPES | April 18, 2012 |
| Mailing address | Po Box 461, Moroni, UT 84646-0461 |
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