Individual
BRAD TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5323 WOODROW ST STE 102, MURRAY, UT 84107-5853
(801) 913-1010
(801) 262-3897
Mailing address
5444 SOUTH GREEN STREET, MURRAY, UT 84123
(801) 284-1702
(801) 262-3897
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
7777106-1206
UT
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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