Individual
TYLER CORCORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC, ITAT
Contact information
Practice address
3737 BROCK RD, DULUTH, GA 30096-2724
(706) 910-9834
Mailing address
1362 WOODLAND VIEW RD, LAWRENCEVILLE, GA 30043-7512
(706) 910-9834
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002548
GA
Other
Enumeration date
09/29/2015
Last updated
09/23/2022
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