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Organization
TANNER MARTINEZ CHIROPRACTIC LLC
Active
Organization
TANNER MARTINEZ CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN JAMES TANNER (DOCTOR)
(904) 819-9110
Entity
Organization
Contact information
Practice address
2200 N PONCE DE LEON BLVD, SUITE 1, ST AUGUSTINE, FL 32084-2600
(904) 819-9110
(904) 819-9310
Mailing address
2200 N PONCE DE LEON BLVD, SUITE 1, ST AUGUSTINE, FL 32084-2600
(904) 819-9110
(904) 819-9310
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH10578
FL
111NI0013X
Independent Medical Examiner Chiropractor
CH10578
FL
Other
Enumeration date
05/29/2012
Last updated
05/29/2012
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