Individual
TYLER CHARLES SLOCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5823 WIDEWATERS PKWY, EAST SYRACUSE, NY 13057-3084
(315) 418-4007
Mailing address
8938 CENTER POINTE DR, BALDWINSVILLE, NY 13027-1431
(315) 663-5880
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003011
NY
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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