Provider Demographics
NPI:1922348549
Name:BEAN, TIFFINEY RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:TIFFINEY
Middle Name:RENEE
Last Name:BEAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 SAMFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-4252
Mailing Address - Country:US
Mailing Address - Phone:229-894-7555
Mailing Address - Fax:
Practice Address - Street 1:1817 SAMFORD AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-4252
Practice Address - Country:US
Practice Address - Phone:229-888-1005
Practice Address - Fax:229-888-8375
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008737111N00000X
AL2433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor