Individual
ANTHONY TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA(ASCP)CM
Contact information
Practice address
607 MATADOR CT, BOSSIER CITY, LA 71111-8232
(601) 467-4646
Mailing address
607 MATADOR CT, BOSSIER CITY, LA 71111-8232
(601) 467-4646
Taxonomy
Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
Primary
000512
NY
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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