Individual
TANNER SAMUEL CANADAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(541) 732-5686
Mailing address
1334 REDDY AVE, MEDFORD, OR 97504-7056
(541) 290-7073
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
64960
OR
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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