Provider Demographics
NPI:1710739412
Name:TARRY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:TARRY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-302-8604
Mailing Address - Street 1:13000 W 87TH STREET PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2879
Mailing Address - Country:US
Mailing Address - Phone:913-400-2014
Mailing Address - Fax:
Practice Address - Street 1:13000 W 87TH STREET PKWY STE 105
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2879
Practice Address - Country:US
Practice Address - Phone:913-400-2014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty