Individual
TANNER JAMES VICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
404 S ADAMS ST, SOUTH HUTCHINSON, KS 67505-1950
(620) 921-1307
Mailing address
404 S ADAMS ST, SOUTH HUTCHINSON, KS 67505-1950
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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