Individual
JEFFREY A TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6249
(304) 927-6837
Mailing address
42 SNYDERS RUN, GANDEEVILLE, WV 25243-8704
(304) 927-6249
(304) 927-6837
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT001303
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT001303
WV BD OF PHYSICAL THERAPY
WV
Enumeration date
05/04/2007
Last updated
07/08/2007
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