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Individual

TYLER BLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6 OAKWOOD DR, JACKSONVILLE, IL 62650-3388
(217) 473-8494
Mailing address
6 OAKWOOD DR, JACKSONVILLE, IL 62650-3388

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/28/2015
Last updated
07/28/2016
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