Individual
TANNER LUKE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1470 INDUSTRIAL DR NW, ROCHESTER, MN 55901-0700
(507) 322-7751
Mailing address
1470 INDUSTRIAL DR NW, ROCHESTER, MN 55901-0700
(507) 322-7751
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/03/2020
Last updated
10/03/2020
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