Individual
TYLER BRUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
10 DOCTORS PARK, GIBSON CITY, IL 60936-2009
(217) 781-2560
Mailing address
881 N 200E RD, GIBSON CITY, IL 60936-7194
(217) 781-2307
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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