Individual
DAVID BENJAMIN TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4800 EAST 17160 NORTH, MORONI, UT 84646-0028
(435) 436-5321
(435) 436-5322
Mailing address
PO BOX 28, MORONI, UT 84646-0028
(435) 436-5321
(435) 436-5322
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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