IndividualActive
Keith Tanner
NPI 1134858236 · Contractor · Detroit, MI
Keith Tanner is a Contractor provider in Detroit, MI (NPI 1134858236).
Provider details
- NPI number
- 1134858236
- Entity type
- Individual
- Primary specialty
- ContractorOther Service Providers
- Sex
- Male
- Sole proprietor
- Yes
Practice location
16656 Parkside St
Detroit, MI 48221-3153
Phone: (313) 989-5536
Street-level locationGet directions
Mailing address
16656 Parkside St
Detroit, MI 48221-3153
Registry dates
- Enumerated
- 2022-06-06
- Last updated
- 2022-06-06
- Certified
- 2022-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.