Individual
DR. LUCAS AARON TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
132 DEPOT ST, GARDNER, IL 60424-9401
(405) 795-3332
Mailing address
21461 W ELMWOOD AVE, WILMINGTON, IL 60481-9613
(405) 795-3332
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038013364
IL
111N00000X
Chiropractor
3963
OK
Other
Enumeration date
11/25/2009
Last updated
10/26/2022
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