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1730799867
TANNER JAY HALLOCK
GRAND JUNCTION, CO
NPI
1730799867
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2020-08-04
Last Update Date
2020-08-04
Business Address
TANNER JAY HALLOCK
1100 NORTH AVE
GRAND JUNCTION, CO 81501-3122
Phone number: 720-579-8682
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Mailing Address
TANNER JAY HALLOCK
1100 NORTH AVE
GRAND JUNCTION, CO 81501-3122
Phone number:
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