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1104537398
TANNER MAXWELL
CORPUS CHRISTI, TX
NPI
1104537398
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: 2147852)
Enumeration Date
2022-12-08
Last Update Date
2022-12-08
Business Address
Mr. TANNER MAXWELL PTA
5026 DEEPWOOD CIR
CORPUS CHRISTI, TX 78415-2901
Phone number: 361-854-2278
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Mailing Address
Mr. TANNER MAXWELL PTA
5026 DEEPWOOD CIR
CORPUS CHRISTI, TX 78415-2901
Phone number: 361-854-2278
Copy
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