Dr. Lucas Tanner, LLC

NPI #1194448480 in Gardner, Illinois

Provider Information

NPI Number: 1194448480
Entity Type: Organization
Organization Name: Dr. Lucas Tanner, LLC
Primary Specialty: Clinic/Center
Enumeration Date: Sep 21, 2022
Last Updated: Oct 26, 2022

Practice Location

Address: 132 DEPOT ST
City: Gardner
State: Illinois
ZIP Code: 60424-9401
Phone: (405) 795-3332

Authorized Official

Name: DR. LUCAS AARON TANNER, DC
Title: OWNER
Phone: (405) 795-3332

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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