Individual
DR. DUSTIN JAMES TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
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
(315) 224-4042
(904) 819-9310
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH 10578
FL
111N00000X
Chiropractor
X012022-1
NY
Other
Enumeration date
11/05/2009
Last updated
05/29/2012
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