Individual
TANNER WAYNE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, ATC
Contact information
Practice address
321 MAIN ST, BOONVILLE, MO 65233-1565
(660) 882-5775
Mailing address
321 MAIN ST, BOONVILLE, MO 65233-1565
(660) 882-5775
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2021015944
MO
Other
Enumeration date
05/04/2021
Last updated
04/23/2026
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