Jim Tanner

NPI #1023749629 in Pueblo, Colorado

Provider Information

NPI Number: 1023749629
Entity Type: Individual
Name: Jim Tanner
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Jun 23, 2022
Last Updated: Jun 23, 2022

Practice Location

Address: 503 N MAIN ST STE 539
City: Pueblo
State: Colorado
ZIP Code: 81003-3133
Phone: (719) 766-9299

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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