Most Relevant Information
Provider Data
| NPI Number: | 1003385634 |
| Provider Name: | BRENDAN CLARK TANNER PT, DPT, NCS |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 2002027897 |
Most Important Dates
| Enumeration Date: | 11/13/2018 |
| Last Updated: | 11/13/2018 |
Provider Practice Location
3145 WALTER AVE
MAPLEWOOD
MO
631433913
Practice Location Phone/Fax
| Phone: | 3146076384 |
| Fax: |
Provider Mailing Location
3145 WALTER AVE
MAPLEWOOD
MO
631433913
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |