Individual
CHARLES CLARKE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, COMT, ATC, CSCS
Contact information
Practice address
7400 BEAUFONT SPRINGS DR, SUITE 120, RICHMOND, VA 23225-5556
(804) 320-2220
(804) 320-2226
Mailing address
7400 BEAUFONT SPRINGS DR, SUITE 120, RICHMOND, VA 23225-5556
(804) 320-2220
(804) 320-2226
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2305202905
VA
Other
Enumeration date
07/25/2006
Last updated
11/04/2015
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