| Doctor Name: | DAVID ERIC TANNER |
| NPI Number: | 1609897578 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 38635 |
| Business Practice Address: | 5387 Manhattan Cir Suite 201 Boulder, CO - 803034284 |
| Business Phone Number: | 3034942705 |
| Business Fax Number: | 3034942706 |
| Mailing Address: | 5387 Manhattan Cir, Suite 201 BOULDER |
| State: | CO |
| Postal Code: | 803034284 |
| Phone Number: | 3034942705 |
| Fax Number: | 3034942706 |
| NPI Enumeration Date: | 07/23/2006 |
| NPI Last Update Date: | 12/06/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 38635 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |