Provider Demographics
NPI:1194032300
Name:INNES-LANG, TAMMY LYNN (DC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:INNES-LANG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 BECKETT RD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1565
Mailing Address - Country:US
Mailing Address - Phone:856-467-3535
Mailing Address - Fax:856-467-1911
Practice Address - Street 1:553 BECKETT RD
Practice Address - Street 2:SUITE 406
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1565
Practice Address - Country:US
Practice Address - Phone:856-467-3535
Practice Address - Fax:856-467-1911
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00471600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor