Organization
JOHN R TANNER OD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R TANNER OD (OWNER)
(219) 508-6465
Entity
Organization
Contact information
Practice address
18431 N 91ST AVE, STE 1, PEORIA, AZ 85382-0817
(219) 508-6465
Mailing address
18431 N 91ST AVE, STE 1, PEORIA, AZ 85382-0817
(219) 508-6465
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1935
AZ
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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