Dr. Lucas Tanner, Llc | |
132 Depot St Gardner IL 60424-9401 | |
(405) 795-3332 | |
Not Available |
Full Name | Dr. Lucas Tanner, Llc |
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Speciality | Clinic/center |
Location | 132 Depot St, Gardner, Illinois |
Authorized Official Name and Position | Lucas Aaron Tanner (OWNER) |
Authorized Official Contact | 4057953332 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dr. Lucas Tanner, Llc 21461 W Elmwood Ave Wilmington IL 60481-9613 Ph: (405) 795-3332 | Dr. Lucas Tanner, Llc 132 Depot St Gardner IL 60424-9401 Ph: (405) 795-3332 |
NPI Number | 1194448480 |
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Provider Enumeration Date | 09/21/2022 |
Last Update Date | 10/26/2022 |
Identifier | Type | State | Issuer |
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1194448480 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |