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1750667762
BRANDON DEE TANNER
TWIN FALLS, ID
NPI
1750667762
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1058)
Enumeration Date
2011-10-24
Last Update Date
2021-03-17
Business Address
BRANDON DEE TANNER PA
388 MARTIN ST
TWIN FALLS, ID 83301-4544
Phone number: 208-734-0451
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Mailing Address
BRANDON DEE TANNER PA
794 EASTLAND DR
TWIN FALLS, ID 83301-6856
Phone number: 208-737-6718
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