Provider Demographics
NPI:1407069776
Name:DR. DANIEL S. TIERNEY, LLC
Entity Type:Organization
Organization Name:DR. DANIEL S. TIERNEY, LLC
Other - Org Name:TIERNEY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:TIERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-444-2158
Mailing Address - Street 1:801 TWELVE OAKS CENTER DR
Mailing Address - Street 2:SUITE 809
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-4601
Mailing Address - Country:US
Mailing Address - Phone:952-444-2158
Mailing Address - Fax:
Practice Address - Street 1:801 TWELVE OAKS CENTER DR
Practice Address - Street 2:SUITE 809
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4601
Practice Address - Country:US
Practice Address - Phone:952-444-2158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty