Individual
TANNER WAYNE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7449 EASTCHASE PKWY, MONTGOMERY, AL 36117-6846
(334) 747-4030
Mailing address
2702 CUNNINGHAM CT, OPELIKA, AL 36801-6864
(334) 403-0222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39104
AL
Other
Enumeration date
09/05/2018
Last updated
01/18/2022
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