Individual
MR. TYLER BEAUREGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CSCS
Contact information
Practice address
453 W 10TH AVE, 228 ATWELL HALL, COLUMBUS, OH 43210
(406) 208-5794
Mailing address
453 W 10TH AVE, 228 ATWELL HALL, COLUMBUS, OH 43210
(406) 208-5794
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT006059
OH
Other
Enumeration date
08/09/2012
Last updated
09/26/2019
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