Provider Demographics
NPI:1710691613
Name:HALE, TANNER (DC)
Entity Type:Individual
Prefix:
First Name:TANNER
Middle Name:
Last Name:HALE
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 1:152 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-3050
Mailing Address - Country:US
Mailing Address - Phone:828-245-0202
Mailing Address - Fax:828-245-0422
Practice Address - Street 1:152 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3050
Practice Address - Country:US
Practice Address - Phone:828-245-0202
Practice Address - Fax:828-245-0422
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor