Individual
MR. CYLE WILLIAM ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1750 E LAKE SHORE DR # LL1, DECATUR, IL 62521-3803
(217) 464-1459
(217) 464-1476
Mailing address
1521 W SUNSET AVE, DECATUR, IL 62522-2741
(217) 972-1219
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003125
IL
Other
Enumeration date
03/01/2023
Last updated
03/08/2023
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