JACOB FARLEY TANNER

CREVE COEUR, MO
NPI1871016105
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO  2015026272)
Enumeration Date2017-07-19
Last Update Date2017-08-03
Business Address
JACOB FARLEY TANNER MS, ATC, LAT
1054 TOWN AND FOUR PARKWAY DR
CREVE COEUR, MO 63141
Phone number: 314-803-7792
Mailing Address
JACOB FARLEY TANNER MS, ATC, LAT
1054 TOWN AND FOUR PARKWAY DR
CREVE COEUR, MO 63141-6225
Phone number:
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