Jeffrey Brent Tanner | Virginia Beach, VA • PECOS Search

Jeffrey Brent Tanner

Massage Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

1492 S Independence Blvd Ste 100, Virginia Beach, VA 23462-5252

(757) 632-0974 (239) 220-8840

PECOS Enrollment

Based on the most recent information from CMS, provider Jeffrey Brent Tanner does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 9 days ago.

Profile Details

Provider ID
1598635898
Provider Type
Individual
Full Name
Tanner, Jeffrey Brent
Title
Mr.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
11/11/2025
Last Updated
11/11/2025

Contact Information

Practice Location

1492 S Independence Blvd Ste 100, Virginia Beach, VA 23462-5252

Unlisted Fax

Mailing Location

1012 Valmire Dr, Chesapeake, VA 23320-4730

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 225700000X Primary	Description Massage Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License 0019017830 Virginia