Individual
DR. GLEN J TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
34597 N 60TH ST, SCOTTSDALE, AZ 85262-5240
(480) 595-6100
(480) 595-6102
Mailing address
6795 E EAGLE FEATHER RD, SCOTTSDALE, AZ 85262-7360
(480) 703-4536
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
5739
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0244750
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
12/14/2006
Last updated
07/08/2007
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