Individual
LAUREN TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
800 STATE ST, APT 208, WEST COLUMBIA, SC 29169-7101
(978) 793-2636
Mailing address
800 STATE ST, APT 208, WEST COLUMBIA, SC 29169-7101
(978) 793-2636
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1234
SC
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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