Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TANNER PATRICK KRUMWIEDE, MS, LAT, ATC
Active Sole ProprietorTANNER PATRICK KRUMWIEDE, MS, LAT, ATC is a Athletic Trainer healthcare provider located in JERSEYVILLE, Illinois. NPI 1063156180 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · JERSEYVILLE, IL
Registration Details
- NPI Number
- 1063156180
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 25, 2022 (4.263167171786 yrs)
- Last Updated
- Apr 25, 2022
- License
-
096004524 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
800 N STATEJERSEYVILLE, IL, 620526205Browse IL providers · Browse ZIP 62052
- Phone
- 6184985521
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.