Individual
LISA MARIE TANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
311 S CLARK ST STE 275, CARROLL, IA 51401-3086
(712) 210-1414
Mailing address
311 S CLARK ST STE 275, CARROLL, IA 51401-3086
(712) 210-1414
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P30723
IA
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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