Search › Illinois › 2255A2300X
Tynan Davis, ATC, LAT
NPI 1720570096 · on the registry since 2018 · sole proprietor
Practice
- Address
- 839 W Roosevelt Rd
Chicago, IL 60608 - Phone
- (510) 301-3364
- Clinicians at this address
- 7
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-06-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois