Individual
MR. GORDON R TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6421 SW 13TH ST, GAINESVILLE, FL 32608-5419
(352) 378-7891
Mailing address
2420 NE 53RD TER, GAINESVILLE, FL 32609-2623
(352) 381-3506
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA12950
FL
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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