Individual
DR. BRENDAN CLARK TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, NCS
Contact information
Practice address
3145 WALTER AVE, MAPLEWOOD, MO 63143-3913
(314) 607-6384
Mailing address
3145 WALTER AVE, MAPLEWOOD, MO 63143-3913
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2002027897
MO
Other
Enumeration date
11/13/2018
Last updated
11/13/2018
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