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Individual

TYLER ORTLIEB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1873
(937) 641-3939
Mailing address
151 KENNEDY BLVD, PO BOX 597, LEESBURG, OH 45135-0318
(937) 218-0254

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000007012
OH

Other

Enumeration date
11/01/2011
Last updated
03/04/2014
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