Individual
TANNER LIGHTBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
610 CALIFORNIA AVE, LIBBY, MT 59923-1902
(406) 293-6236
Mailing address
610 CALIFORNIA AVE, LIBBY, MT 59923-1902
(406) 293-6236
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4229
MT
Other
Enumeration date
06/29/2021
Last updated
07/12/2021
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