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1821872987
TANNER BRYCE WILSON
LEBANON, KY
NPI
1821872987
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QP2000X Clinic/Center, Physical Therapy
(Licence: KY 008824)
Enumeration Date
2023-08-21
Last Update Date
2023-08-21
Business Address
Dr. TANNER BRYCE WILSON PT, DPT
703 E MAIN ST UNIT 1
LEBANON, KY 40033-8696
Phone number: 270-699-9503
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Mailing Address
Dr. TANNER BRYCE WILSON PT, DPT
145 HEART LN
CAMPBELLSVILLE, KY 42718-7376
Phone number: 270-670-2823
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