Individual
TYLER JAMES JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1910 SOUTH RD, POUGHKEEPSIE, NY 12601-6027
(845) 454-0120
Mailing address
807 ROMAN WAY, NEWBURGH, NY 12550-8656
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00264-1
NY
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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