Individual
JOHN TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2005 PENMAR DR, LA VERGNE, TN 37086-3185
(615) 651-1059
Mailing address
2005 PENMAR DR, LA VERGNE, TN 37086-3185
(615) 651-1059
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0000014035
TN
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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