Individual
LLOYD ALTON TANTUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1732 W BROADWAY AVE, MARYVILLE, TN 37801-5510
(865) 982-6761
Mailing address
702 S FOOTHILLS PLAZA DR, MARYVILLE, TN 37801-2300
(865) 982-6761
(865) 982-7402
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
ODT694
TN
152WC0802X
Corneal and Contact Management Optometrist
OPT-OPT-LIC-823
MT
Other
Enumeration date
03/17/2006
Last updated
06/27/2017
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