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Individual

EVAN RICHARD TANKERSLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
3129 MOLLY DR, HUNTSVILLE, TX 77340-6547
(256) 200-2788
Mailing address
3129 MOLLY DR, HUNTSVILLE, TX 77340-6547

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BEG849094531
BCBS ALABMA
AL
Enumeration date
06/12/2022
Last updated
09/11/2025
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