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NPI Code Detail

MEDICARE: TYLER VANCAMP ATC

MEDICARE:   TYLER  VANCAMP  ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
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General Provider Information

NPI Number : 1972272839
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER VANCAMP ATC
Provider Business Mailing Address
First Line : 1120 E IOWA ST
Second Line :
City : EVANSVILLE
State : IN
Zip : 47711-5250
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 138 N LUCRETIA ST
Second Line :
City : OAKLAND CITY
State : IN
Zip : 47660-1038
Country : US
Telephone Number : 260-446-7487
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2021
Last Update Date : 09/13/2021

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Directions to “ TYLER VANCAMP ATC” Practice Location

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