Individual
TANNER RYAN WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
316 WINNOW DR, CLAYTON, DE 19938-3531
(302) 922-4090
Mailing address
316 WINNOW DR, CLAYTON, DE 19938-3531
(302) 922-4090
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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