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1720570096
TYNAN HANCOCK DAVIS
CHICAGO, IL
NPI
1720570096
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096.004298)
Enumeration Date
2018-06-03
Last Update Date
2018-06-03
Business Address
Mr. TYNAN HANCOCK DAVIS ATC, LAT
839 W ROOSEVELT RD
CHICAGO, IL 60608-1530
Phone number: 510-301-3364
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Mailing Address
Mr. TYNAN HANCOCK DAVIS ATC, LAT
1831 PARKER ST
BERKELEY, CA 94703-1919
Phone number: 510-301-3364
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