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Organization
TANZAR CHIROPRACTIC WELLCARE CENTER
Active
Organization
TANZAR CHIROPRACTIC WELLCARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF S TANZAR D.C (OWNER)
(434) 385-1110
Entity
Organization
Contact information
Practice address
1088 VISTA PARK DR, SUITE C, FOREST, VA 24551-2761
(434) 385-1110
(434) 385-1115
Mailing address
1088 VISTA PARK DR, SUITE C, FOREST, VA 24551-2761
(434) 385-1110
(434) 385-1115
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001938
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00W170T01
MEDICARE INDIVIDUAL PTAN
VA
01
—
287170
ANTHEM BLUE CROSS BLUE SH
VA
01
—
C09304
MEDICARE GROUP PTAN
VA
Enumeration date
01/29/2007
Last updated
07/23/2013
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