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Individual
DR. TANNER DICKERSON
Active
Individual
DR. TANNER DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC.4491
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497147177
ILLUME CHIROPRACTIC NPI
OH
01
—
152845874
TANNER DICKERSON NPI
OH
Enumeration date
01/26/2015
Last updated
06/03/2016
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