Individual
MRS. PHYLLIS A TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-4157
(423) 844-4149
Mailing address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-4157
(423) 844-4149
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000001415
TN
Other
Enumeration date
06/30/2006
Last updated
02/09/2009
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