Search › Missouri › 2255A2300X
Jacob Tanner, MS, ATC, LAT
NPI 1871016105 · on the registry since 2017 · sole proprietor
Practice
- Address
- 1054 Town And Four Parkway Dr
Creve Coeur, MO 63141 - Phone
- (314) 803-7792
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-08-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri