Individual
TANNER DEAN FORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2108 HORTON ST, FORT SCOTT, KS 66701-3141
(620) 704-0888
Mailing address
709 N CAYUGA ST, FRONTENAC, KS 66763-2072
(620) 704-0888
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/30/2019
Last updated
05/30/2019
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