Individual
MR. TYLER JAMES SKONIECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, NREMT-B
Contact information
Practice address
91 STADIUM DR, STALLINGS EVANS SPORTS MEDICINE CENTER, CHAPEL HILL, NC 27515
(919) 962-2067
Mailing address
57 DEER PATH DR, BERWICK, PA 18603-5107
(570) 855-4297
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
1059757
PA
146N00000X
Basic Emergency Medical Technician
P561644
NC
2255A2300X
Athletic Trainer
Primary
LAT5788
NC
Other
Enumeration date
09/29/2023
Last updated
12/12/2025
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