Individual
PHILIP GLENN TANKERSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
2015 CHEROKEE AVE SW, SUITE B, CULLMAN, AL 35055-5552
(256) 737-9999
(256) 739-5833
Mailing address
2015 CHEROKEE AVE SW STE B, CULLMAN, AL 35055-5552
(256) 737-9999
(256) 739-5833
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1052
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70834
BLUE CROSS BLUE SHIELD
AL
Enumeration date
10/02/2006
Last updated
07/08/2007
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