Organization
GARY TENNANT DC
Active
Other names
Functional Medicine Valparaiso
Organization subpart
No
Provider details
NPI number
Authorized official
GARY TENNANT DC (OWNER)
(708) 275-4698
Entity
Organization
Contact information
Practice address
2590 MORTHLAND DR, VALPARAISO, IN 46385-6701
(219) 232-9404
(219) 293-8011
Mailing address
2590 MORTHLAND DR, VALPARAISO, IN 46385-6701
(219) 232-9404
(219) 293-8011
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002905A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08002905A
INDIANA LICENSE NUMBER
IN
Enumeration date
06/27/2017
Last updated
07/21/2022
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