NPI 1104008333

Tyler Brucker, ATC

Practitioner Athletic Trainer Gibson City, IL

Practice location

Address: 10 Doctors Park, Gibson City, IL 60936-2009
Phone: (217) 781-2560
Mailing address: 881 N 200e Rd, Gibson City, IL 60936-7194

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Illinois →

Registry record

NPI: 1104008333
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Nov 2007
Record last updated: 29 Nov 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.