Individual
JOSHUA TENNYCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1916 EAST G AVE, PARCHMENT, MI 49004
(269) 488-1100
Mailing address
5705 BROOKHAVEN DRIVE, RACINE, WI 53406
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001699
MI
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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