Individual
TANNER JAY HALLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 NORTH AVE, GRAND JUNCTION, CO 81501-3122
(720) 579-8682
Mailing address
1100 NORTH AVE, GRAND JUNCTION, CO 81501-3122
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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