NPI 1902163678
Tyler Steven Poulson
Practice location
- Address
- 21260 North 1450 East, Moroni, UT 84646
- Phone
- (435) 445-5200
- Fax
- (435) 445-5201
- Mailing address
- PO Box 461, Moroni, UT 84646-0461
Registered specialties
Substance Abuse Rehabilitation Facility
Primary
Registry record
- NPI
- 1902163678
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 18 Apr 2012
- Record last updated
- 18 Apr 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.