IndividualActive
Paul Tanner, MBA, CCA
NPI 1760607428 · Anaplastologist · Bountiful, UT
Provider details
- NPI number
- 1760607428
- Entity type
- Individual
- Primary specialty
- AnaplastologistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- MBA, CCA
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Ocularist156FX1700X
Eye and Vision Services Providers
- Prosthetist224P00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Medical Art Specialist/Technologist246ZA2600X
Technologists, Technicians & Other Technical Service Providers
Practice location
1455 S 500 W Ste D
Bountiful, UT 84010-8252
Phone: (801) 997-0545
Fax: (888) 977-5399
Approximate (ZIP-level) locationGet directions
Mailing address
3474 S 100 E
Bountiful, UT 84010-6605
Registry dates
- Enumerated
- 2007-04-16
- Last updated
- 2024-10-31
- Certified
- 2024-10-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.