IndividualActive
Gavin Tanis, MS, LAT, ATC
NPI 1205660263 · Athletic Trainer · Lewiston, ME
Provider details
- NPI number
- 1205660263
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- MS, LAT, ATC
- Sex
- Male
- Sole proprietor
- No
- License
- AT970 (ME)
Mailing address
157 Central Ave
Lewiston, ME 04240-5303
Registry dates
- Enumerated
- 2024-08-30
- Last updated
- 2024-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.