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Individual
PAUL BENJAMIN TANNER
Active
Individual
PAUL BENJAMIN TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, CCA
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
—
—
224P00000X
Prosthetist
—
—
229N00000X
Anaplastologist
Primary
—
—
246ZA2600X
Medical Art Specialist/Technologist
—
—
Other
Enumeration date
04/16/2007
Last updated
10/31/2024
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