Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tyler Zachary Bouchard

Individual provider Athletic Trainer · NPI 1508530551

Tyler Zachary Bouchard is an Athletic Trainer in Columbia, South Carolina. Licensed in South Carolina. Registered with an NPI since 2021.

Licensed in
SC
In the registry since
2021

Practice location Address checks out

1302 Heyward St
Columbia, SC 29208-3407
Phone: (262) 765-1267
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2000038516 (SC)

Record details

NPI number1508530551
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 3, 2021
Last updated in NPPESAugust 3, 2021
Certification dateAugust 3, 2021

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