Provider Demographics
NPI:1164804399
Name:TARRY CHIROPRACTIC PLC
Entity Type:Organization
Organization Name:TARRY CHIROPRACTIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:TARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-290-6272
Mailing Address - Street 1:6427 CENTURION DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-8295
Mailing Address - Country:US
Mailing Address - Phone:517-290-6272
Mailing Address - Fax:
Practice Address - Street 1:6427 CENTURION DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-8295
Practice Address - Country:US
Practice Address - Phone:517-290-6272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Multi-Specialty
No111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty