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Individual

DR. DAVID ROSS TANNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
212 MAIN ST, LINCOLN PARK, NJ 07035-3700
(973) 268-7723
(973) 628-7742
Mailing address
17 SUNRISE WAY, TOWACO, NJ 07082-1547
(973) 334-2664
(973) 682-7742

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
MCC 00228900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22 24230010
HORIZON BC BS
NJ
Enumeration date
04/06/2007
Last updated
07/08/2007
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