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Individual

MR. BRIAN L TACKITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
401 E SPRUCE ST, GARDEN CITY, KS 67846-5679
(620) 272-2610
Mailing address
7995 W RIVER RD, HOLCOMB, KS 67851-9094
(620) 277-2811

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
55672
KS

Other

Enumeration date
10/15/2008
Last updated
11/01/2022
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