MATTHEW JASON TANNER

LOGANSPORT, IN
NPI1396395067
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IN  28177692A)
Enumeration Date2019-09-16
Last Update Date2019-09-16
Business Address
MATTHEW JASON TANNER
1015 MICHIGAN AVE
LOGANSPORT, IN 46947-1526
Phone number: 574-722-5151
Mailing Address
MATTHEW JASON TANNER
3203 SUSAN DR
KOKOMO, IN 46902-7506
Phone number: 765-419-0610
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