Individual
DR. TYLER ROSS HANNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
412 N 200 E, LOGAN, UT 84321-4038
(435) 713-2800
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 713-2800
(435) 713-2836
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13680528-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
R3693
AZ
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
05/28/2021
Last updated
09/11/2024
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