Individual
BOBBY TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
305 COMMERCE DR, MULLINS, SC 29574-6241
(843) 423-7510
(843) 423-9242
Mailing address
486 GREENVIEW DR, JOHNSONVILLE, SC 29555-6605
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8580
SC
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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