Individual
MR. TYNAN HANCOCK DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
839 W ROOSEVELT RD, CHICAGO, IL 60608-1530
(510) 301-3364
Mailing address
1831 PARKER ST, BERKELEY, CA 94703-1919
(510) 301-3364
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004298
IL
Other
Enumeration date
06/03/2018
Last updated
06/03/2018
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