Individual
TYSON R TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1938 S DOBSON RD, MESA, AZ 85202-5658
(480) 777-1649
(480) 894-2054
Mailing address
545 S BROADWAY, SUITE #500, DENVER, CO 80209-4067
(720) 570-0660
(720) 570-3223
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1690
AZ
Other
Enumeration date
07/01/2009
Last updated
07/01/2009
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