Individual
MR. JOHN TYLER FLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., A.T.C.
Contact information
Practice address
111 17TH AVE E STE 101, ALEXANDRIA, MN 56308-3734
(320) 762-1144
(320) 762-1935
Mailing address
111 17TH AVE E STE 101, ALEXANDRIA, MN 56308-3734
(320) 762-1144
(320) 762-1935
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1805
MN
2255A2300X
Athletic Trainer
279-04/06
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020402094
NATABOC CERTIFICATION #
—
01
—
1805
ATR REGISTRATION #
MN
01
—
279-04/06
ATC LICENSURE #
ND
Enumeration date
09/06/2006
Last updated
08/07/2014
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