Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael Tyler Wilson, ATC, LAT

Individual provider Athletic Trainer · NPI 1053864306

Michael Tyler Wilson, ATC, LAT is an Athletic Trainer in Fayette, Missouri. Licensed in Missouri. Registered with an NPI since 2016.

Licensed in
MO
In the registry since
2016
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

See every abbreviation used in this directory →

Practice location Address checks out

411 Central Methodist Sq
Fayette, MO 65248-1104
Phone: (636) 577-5062
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2016023484 (MO)

Record details

NPI number1053864306
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC , LAT
Sole proprietorNo
NPI enumeratedAugust 3, 2016
Last updated in NPPESAugust 3, 2016

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