Individual
SUSAN TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-9247
(254) 724-8772
Mailing address
PO BOX 844658, TEMPLE, TX 76508-4658
(254) 724-9247
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT06476
TX
Other
Enumeration date
01/05/2010
Last updated
01/27/2022
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