Organization
DR. LUCAS TANNER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCAS AARON TANNER DC (OWNER)
(405) 795-3332
Entity
Organization
Contact information
Practice address
132 DEPOT ST, GARDNER, IL 60424-9401
(405) 795-3332
Mailing address
21461 W ELMWOOD AVE, WILMINGTON, IL 60481-9613
(405) 795-3332
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/21/2022
Last updated
10/26/2022
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