Cire Nicolas Juanico Tan
NPI #1093536658 in Lindenhurst, Illinois
Provider Information
- NPI Number
- 1093536658
- Entity Type
- Individual
- Name
- Cire Nicolas Juanico Tan
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Enumeration Date
- Oct 17, 2024
- Last Updated
- Oct 17, 2024
Practice Location
- Address
- 870 GREENWOOD DR
- City
- Lindenhurst
- State
- Illinois
- ZIP Code
- 60046-1717
- Phone
- (224) 518-3215
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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