Provider Demographics
NPI:1619739091
Name:ELSNER, TUCKER BRAIDEN (DC)
Entity Type:Individual
Prefix:DR
First Name:TUCKER
Middle Name:BRAIDEN
Last Name:ELSNER
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 1:217 BLAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:SPRING CREEK
Mailing Address - State:NV
Mailing Address - Zip Code:89815-6145
Mailing Address - Country:US
Mailing Address - Phone:775-934-8722
Mailing Address - Fax:
Practice Address - Street 1:263 SPRING VALLEY PKWY STE E
Practice Address - Street 2:
Practice Address - City:SPRING CREEK
Practice Address - State:NV
Practice Address - Zip Code:89815-6826
Practice Address - Country:US
Practice Address - Phone:775-753-9395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB02027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor