Provider Demographics
NPI:1942250881
Name:TANI, JOHN B JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:TANI
Suffix:JR
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 1:300 E 4500 S
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3939
Mailing Address - Country:US
Mailing Address - Phone:801-269-8989
Mailing Address - Fax:
Practice Address - Street 1:300 E 4500 S
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3939
Practice Address - Country:US
Practice Address - Phone:801-269-8989
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT278120-1202111N00000X
FLCH3930111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor