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1801671862
TANNER ELIJAH KOON
SPARTANBURG, SC
NPI
1801671862
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 27805)
Enumeration Date
2023-08-29
Last Update Date
2023-09-18
Business Address
TANNER ELIJAH KOON NP
101 E WOOD ST
SPARTANBURG, SC 29303-3040
Phone number: 864-560-7025
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Mailing Address
TANNER ELIJAH KOON NP
PO BOX 743070
ATLANTA, GA 30374-3070
Phone number: 864-560-4304
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