Provider Demographics
NPI:1811556426
Name:PRICE, TANNER EGAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:TANNER
Middle Name:EGAN
Last Name:PRICE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 OLD MAIN HL
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84322-6410
Mailing Address - Country:US
Mailing Address - Phone:435-797-9234
Mailing Address - Fax:844-308-5865
Practice Address - Street 1:6410 OLD MAIN HL
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84322-6967
Practice Address - Country:US
Practice Address - Phone:435-797-9234
Practice Address - Fax:844-308-5865
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81038231H00000X
MO2021003749231H00000X
UT12818174-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist