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1174229579
LAKEN RENEE TANNER
WAYCROSS, GA
NPI
1174229579
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 11382)
Enumeration Date
2023-02-07
Last Update Date
2023-02-07
Business Address
LAKEN RENEE TANNER MSPAP, PA-C
1900 TEBEAU ST
WAYCROSS, GA 31501-6357
Phone number: 912-283-3030
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Mailing Address
LAKEN RENEE TANNER MSPAP, PA-C
99 RUFUS RD
WILLACOOCHEE, GA 31650-5400
Phone number: 912-327-0659
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