Individual
TYLER BORCHARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
640 SOUTH INDIANA AVENUE, MASON CITY, IA 50401
(641) 430-4966
Mailing address
640 SOUTH INDIANA AVE, MASON CITY, IA 50401
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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