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Individual

TYLER KARL BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MAE, LAT, ATC

Contact information

Practice address
1 CUMBERLAND SQ, LEBANON, TN 37087-3408
(615) 547-1232
Mailing address
1 CUMBERLAND SQ, LEBANON, TN 37087-3408

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0000001812
TN

Other

Enumeration date
01/14/2019
Last updated
01/14/2019
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