Individual
TANNER DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
589 S STATE ST, PROVO, UT 84606-5056
(801) 429-2000
(801) 429-2001
Mailing address
589 S STATE ST, PROVO, UT 84606-5056
(801) 429-2000
(801) 429-2001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
139697313102
UT
Other
Enumeration date
01/02/2026
Last updated
01/02/2026
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