Provider Demographics
NPI:1134738545
Name:TANK CONSULTATION PLLC
Entity type:Organization
Organization Name:TANK CONSULTATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-974-7313
Mailing Address - Street 1:6095 MCALLISTER CT SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3836
Mailing Address - Country:US
Mailing Address - Phone:517-974-7313
Mailing Address - Fax:
Practice Address - Street 1:6095 MCALLISTER CT SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3836
Practice Address - Country:US
Practice Address - Phone:517-974-7313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty