Provider Demographics
NPI:1710486105
Name:TENBARGE, CLAY (DC)
Entity Type:Individual
Prefix:
First Name:CLAY
Middle Name:
Last Name:TENBARGE
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 1:208 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-2850
Mailing Address - Country:US
Mailing Address - Phone:765-825-3521
Mailing Address - Fax:765-825-8554
Practice Address - Street 1:208 W 20TH ST
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-2850
Practice Address - Country:US
Practice Address - Phone:765-825-3521
Practice Address - Fax:765-825-8554
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003016A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor