Individual
DWAYNE L TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 W BROAD AVE STE B2, ALBANY, GA 31707-4385
(229) 288-7649
Mailing address
1405 GAIL AVE, ALBANY, GA 31707-2610
(229) 288-7649
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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