Individual
TANNER DANIEL BOTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRSS
Contact information
Practice address
231 E GRAHAM AVE, PRYOR, OK 74361-2436
(918) 825-1405
(918) 825-1406
Mailing address
231 E GRAHAM AVE, PRYOR, OK 74361-2436
(918) 825-1405
(918) 825-1406
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/26/2017
Last updated
07/21/2022
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