Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MICHAEL TILLERY, ATC
Active Sole ProprietorMR. MICHAEL TILLERY, ATC is a Athletic Trainer healthcare provider located in LOMPOC, California. NPI 1164980694 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · LOMPOC, CA
Registration Details
- NPI Number
- 1164980694
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 4, 2019 (7.4790440191605 yrs)
- Last Updated
- Mar 4, 2019
- License
-
070402516 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4350 CONSTELLATION RDLOMPOC, CA, 934361033Browse CA providers · Browse ZIP 93436
- Phone
- 8057422900
- Fax
- 8957422917
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in LOMPOC, CA
| Name | Credential | NPI |
|---|---|---|
| MRS. DOLLY CECILIA WUITSCHICK | A.T.C., P.T.A | 1700844974 |
| MR. TOM E BLANCO | MAT, ATC | 1578784294 |
| ANGELA LYNN GONZALEZ | — | 1548756695 |
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.