Provider Demographics
NPI:1588006738
Name:PARIZEK, TANNER (DC)
Entity Type:Individual
Prefix:DR
First Name:TANNER
Middle Name:
Last Name:PARIZEK
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 1:20 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-6015
Mailing Address - Country:US
Mailing Address - Phone:701-240-6595
Mailing Address - Fax:
Practice Address - Street 1:308 2ND ST SW
Practice Address - Street 2:
Practice Address - City:TOWNER
Practice Address - State:ND
Practice Address - Zip Code:58788-4023
Practice Address - Country:US
Practice Address - Phone:701-240-6595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor