Individual
TRAVIS TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 249-0212
Mailing address
1412 N CENTER ST APT 1, MESA, AZ 85201-2607
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/25/2026
Last updated
03/26/2026
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