Provider Demographics
NPI:1104327469
Name:BRYANT, TANNER (PHARMD)
Entity type:Individual
Prefix:
First Name:TANNER
Middle Name:
Last Name:BRYANT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 BRYANT CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:WHITWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37397-3404
Mailing Address - Country:US
Mailing Address - Phone:423-883-2494
Mailing Address - Fax:
Practice Address - Street 1:16773 RANKIN AVE
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:TN
Practice Address - Zip Code:37327-7021
Practice Address - Country:US
Practice Address - Phone:423-949-5056
Practice Address - Fax:423-949-2448
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist