Individual
SETH TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,ATC, LAT,CES
Contact information
Practice address
421 N WOODLAND BLVD, UNIT 8284, DELAND, FL 32723-8300
(386) 822-7029
Mailing address
422 W NEW YORK AVE, APT. D, DELAND, FL 32720-5349
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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