TYLER AUSTIN LONG

COLUMBIA, SC
NPI1417499062
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO  2000025534)
Enumeration Date2016-11-14
Last Update Date2016-11-14
Business Address
-- TYLER AUSTIN LONG ATC
1300 WHEAT ST OFFICE 214
COLUMBIA, SC 29208-0001
Phone number: 636-699-0078
Mailing Address
-- TYLER AUSTIN LONG ATC
1300 WHEAT ST OFFICE 214
COLUMBIA, SC 29208-0001
Phone number: 636-699-0078
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