Individual
TYLER FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, CES
Contact information
Practice address
1350 FLORIDA AVE, BUILDING # 36087, PORT SAINT JOE, FL 32456
(860) 383-3842
Mailing address
1350 FLORIDA AVE, BUILDING #36087, PORT SAINT JOE, FL 32456
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
003983
NY
2255A2300X
Athletic Trainer
Primary
A0001405
MD
2255A2300X
Athletic Trainer
Primary
A01405
MD
Other
Enumeration date
09/08/2020
Last updated
05/01/2026
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