Individual
TANNER RYAN STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 RUFUS LN, POLSON, MT 59860-8903
(406) 883-2555
(406) 883-2559
Mailing address
104 RUFUS LN, POLSON, MT 59860-8903
(406) 883-2555
(406) 883-2559
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MT
Other
Enumeration date
07/28/2022
Last updated
11/05/2024
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