Individual
SYDNEY LEE TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1400 E HANNA AVE, INDIANAPOLIS, IN 46227
(317) 788-3309
Mailing address
3602 FAIRGROVE DR APT D, INDIANAPOLIS, IN 46227-9640
(574) 340-8793
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003031A
IN
Other
Enumeration date
03/25/2015
Last updated
08/02/2018
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