Individual
MR. GARY A TENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1101 N ALLEN ST, ROBINSON, IL 62454-1168
(618) 544-3125
(618) 546-5185
Mailing address
1101 N ALLEN ST, ROBINSON, IL 62454-1168
(618) 544-3125
(618) 546-5185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036099492
IL
Other
Enumeration date
01/13/2006
Last updated
07/08/2007
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