Individual
DR. KEVIN A TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
114 14TH ST SW, LOVELAND, CO 80537-6341
(970) 587-3937
(970) 622-0648
Mailing address
114 14TH ST SW, LOVELAND, CO 80537-6341
(970) 587-3937
(970) 622-0648
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2816
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12125067
—
CO
Enumeration date
07/20/2006
Last updated
11/01/2022
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