Individual
EVELYN TANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1609 POPLAR LEVEL RD, LOUISVILLE, KY 40217-1359
(502) 634-2175
(502) 634-2158
Mailing address
1609 POPLAR LEVEL RD, LOUISVILLE, KY 40217-1359
(502) 634-2175
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1512
KY
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
12/22/2016
Last updated
09/14/2020
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