Individual
TYLER KROGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LAT, ATC
Contact information
Practice address
1600 W MAIN ST, PEORIA, IL 61606-1027
(319) 429-1194
Mailing address
5933 N CYPRESS DR APT 1305, PEORIA, IL 61615-2621
(319) 429-1194
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096343
IA
Other
Enumeration date
08/10/2017
Last updated
08/14/2021
About Stedi
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