Individual
TANNER LEE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2380 8TH AVE, SUITE 8, PLATTSMOUTH, NE 68048-2367
(402) 296-3433
(402) 296-3531
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2485
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39849
BCBS NE
—
01
—
P00378278
RR MEDICARE
—
Enumeration date
08/02/2006
Last updated
06/25/2016
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