Individual
MR. FRED LEONARD TANNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5000
Mailing address
9517 REDINGTON DR, RICHMOND, VA 23235-4045
(804) 272-8440
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
0001067139
VA
Other
Enumeration date
08/11/2008
Last updated
08/11/2008
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