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General NPI Number Information
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NPI Number | 1962955120
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Entity Type | Individual
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Provider Name | DR. BRIAN TANT
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Gender | Male
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Dates
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Enumeration Date | 07/24/2016
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 2120 E MAIN ST
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City | DUNCAN
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State | SC
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Zip | 29334-9456
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Country | US
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Telephone | 864-433-0422
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Fax |
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Provider Business Mailing Address
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Address Line | 68 GOVERNORS LAKE WAY
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-7380
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Country | US
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Telephone | 706-436-8792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 36683
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License Number State | SC
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