Individual
DR. TANNER DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
305 DOWNTOWNER PLZ, COSHOCTON, OH 43812-1928
(740) 562-5600
Mailing address
PO BOX 773, COSHOCTON, OH 43812-0773
(740) 562-5600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC.4491
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497147177
ILLUME CHIROPRACTIC NPI
OH
01
—
152845874
TANNER DICKERSON NPI
OH
Enumeration date
01/26/2015
Last updated
06/03/2016
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