Individual
TYLER SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1247 E SIENA HEIGHTS DR, ADRIAN, MI 49221-1755
(800) 521-0009
Mailing address
225 S MADISON ST, ADRIAN, MI 49221-2519
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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