Individual provider · Type 1 NPI

Tyler J. Chanthavong, DC

Chiropractor · Green Bay, WI

NPI number 1386433704 Active

Practice location

2300 Riverside Dr Ste 122
Green Bay, WI 54301-1900

Call (920) 664-2559 Map

Mailing address

803 Fredrick Ct Apt 10
Howard, WI 54313-7994

Specialties and licenses

TaxonomyCodeLicense
Chiropractor Primary 111N00000X6307-12 (WI)

Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

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About NPI 1386433704

Tyler J. Chanthavong, DC's National Provider Identifier is 1386433704, issued on May 2, 2025. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Green Bay, WI. The record was last updated on May 5, 2025.