Individual
TANNER ELIJAH KOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
500 PLAZA CIR STE J, CLINTON, SC 29325-7559
(864) 681-0555
(864) 408-8675
Mailing address
500 PLAZA CIR STE J, CLINTON, SC 29325-7559
(864) 681-0555
(864) 408-8675
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
27805
SC
Other
Enumeration date
08/29/2023
Last updated
06/23/2025
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