Individual
TANNER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1460 HIDDEN TRL, CHARLOTTE, MI 48813-8789
(517) 667-0709
Mailing address
1460 HIDDEN TRL, CHARLOTTE, MI 48813-8789
(517) 667-0709
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001540
MI
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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