Individual
TYLER CHENEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3946 ICE WAY, FORT WAYNE, IN 46808
(714) 475-9904
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46808
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003102A
IN
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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