Individual
BENJAMIN TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
901 RANCHO LN STE 135, LAS VEGAS, NV 89106-3826
(702) 383-1958
(702) 366-8545
Mailing address
901 RANCHO LN STE 135, LAS VEGAS, NV 89106-3826
(702) 383-1958
(702) 366-8545
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/09/2014
Last updated
01/09/2014
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