Individual
JOSIE TIERRA TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(762) 235-2495
(706) 238-8013
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11285
GA
Other
Enumeration date
10/06/2022
Last updated
12/16/2022
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