Individual
MICHAEL TZIANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
9536 FANTASY LN, SAINT LOUIS, MO 63126-3116
(314) 602-5948
Mailing address
9536 FANTASY LN, SAINT LOUIS, MO 63126-3116
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2012017982
MO
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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