Individual
MS. JYLISSA NICOLE TAHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1744 N ANDOVER RD, ANDOVER, KS 67002-9472
(316) 218-4600
Mailing address
870 S WATSON LN, WICHITA, KS 67207-2266
(970) 570-7926
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-01071
KS
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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