Provider Demographics
NPI:1386016665
Name:LANNING, TYLER T (DC)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:T
Last Name:LANNING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 S LAKEMAN DR STE D
Mailing Address - Street 2:
Mailing Address - City:BELLBROOK
Mailing Address - State:OH
Mailing Address - Zip Code:45305-2315
Mailing Address - Country:US
Mailing Address - Phone:937-310-1410
Mailing Address - Fax:937-310-1406
Practice Address - Street 1:2011 S LAKEMAN DR STE D
Practice Address - Street 2:
Practice Address - City:BELLBROOK
Practice Address - State:OH
Practice Address - Zip Code:45305-2315
Practice Address - Country:US
Practice Address - Phone:937-310-1410
Practice Address - Fax:937-310-1406
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4568111N00000X, 111NR0400X, 111NX0100X, 111NX0800X, 246ZE0600X, 111NS0005X
OHOH-04568111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH445331Medicaid
OH13644841OtherCAQH