Provider Demographics
NPI:1881834646
Name:DAVIS-TREMAYNE, IAN SHEENE (DC)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:SHEENE
Last Name:DAVIS-TREMAYNE
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 1:465 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2941
Mailing Address - Country:US
Mailing Address - Phone:415-389-8435
Mailing Address - Fax:
Practice Address - Street 1:465 MILLER AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2941
Practice Address - Country:US
Practice Address - Phone:415-389-8435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor