Individual provider · Type 1 NPI

Dustin James Tanner, DC

Chiropractor · St. Augustine, FL

NPI number 1790012201 Active

Practice location

2200 N Ponce De Leon Blvd, Suite #1
St. Augustine, FL 32084-2600

Call (904) 819-9110 Map

Fax (904) 819-9310

Specialties and licenses

TaxonomyCodeLicense
Chiropractor Primary 111N00000XCH 10578 (FL)
Chiropractor 111N00000XX012022-1 (NY)

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 1790012201

Dustin James Tanner, DC's National Provider Identifier is 1790012201, issued on Nov 5, 2009. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in St. Augustine, FL. The record was last updated on May 29, 2012.