| Organization Name: | TANNER PT, LLC |
| NPI Number: | 1013275825 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HOLLY CHRISTINE TANNER (OWNER, PHYSICAL THERAPIST) |
| Mailing Address: | 31 W Superior St Suite 502 Duluth |
| State: | MN US |
| Postal Code: | 558022063 |
| Phone Number: | 2187307920 |
| Fax Number: | 2182602347 |
| NPI Enumeration Date: | 04/30/2012 |
| NPI Last Update Date: | 04/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 5549 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |