Individual
MR. MICHAEL ALAN TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2600 NORTHAMPTON ST, EASTON, PA 18045-2656
(610) 250-0150
Mailing address
2600 NORTHAMPTON ST, EASTON, PA 18045-2656
(610) 250-0150
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE002038L
PA
Other
Enumeration date
10/06/2008
Last updated
10/06/2008
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