Larry Sidney Tanner, RPT

NPI #1336368018 in Shawnee, Oklahoma

Provider Information

NPI Number: 1336368018
Entity Type: Individual
Name: Larry Sidney Tanner, RPT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: RPT
Enumeration Date: Apr 24, 2007
Last Updated: Jan 15, 2019

Practice Location

Address: 1519 N OKLAHOMA AVE
City: Shawnee
State: Oklahoma
ZIP Code: 74804-3848
Phone: (405) 919-0135

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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