Individual
RYAN TISCARENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
621 WEST CHERRY AVE, FLAGSTAFF, AZ 86001
(209) 614-5876
Mailing address
621 WEST CHERRY AVE, FLAGSTAFF, AZ 86001
(209) 614-5876
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
AZ
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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