Individual
TYLER KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 S INDIANA AVE, BLOOMINGTON, IN 47405-7000
(812) 855-4848
Mailing address
1310 CORAL DR, SUN PRAIRIE, WI 53590-1933
(608) 512-8662
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/04/2020
Last updated
08/10/2021
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