Individual
TEODORO C TANG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3349 AMERICAN AVE STE B, JEFFERSON CITY, MO 65109-1079
(573) 635-9655
Mailing address
413 E MCCARTY ST, JEFFERSON CITY, MO 65101-3141
(314) 322-4653
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2006001147
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4400155
UNITED HEALTH CARE
MO
01
—
V08672
MERCY
MO
Enumeration date
07/29/2006
Last updated
08/02/2011
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