Provider Demographics
NPI:1003904244
Name:TENCER, STEVE (D C)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
Last Name:TENCER
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 GOODMAN RD E
Mailing Address - Street 2:SUITE 162
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-9522
Mailing Address - Country:US
Mailing Address - Phone:662-393-8500
Mailing Address - Fax:662-393-9994
Practice Address - Street 1:1941 GOODMAN RD W
Practice Address - Street 2:SUITE 101
Practice Address - City:HORN LAKE
Practice Address - State:MS
Practice Address - Zip Code:38637-1919
Practice Address - Country:US
Practice Address - Phone:662-393-8500
Practice Address - Fax:662-393-9994
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor