Provider Demographics
NPI:1245358860
Name:TANASE, ADAM R (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:R
Last Name:TANASE
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 1:8057 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-5304
Mailing Address - Country:US
Mailing Address - Phone:314-749-9006
Mailing Address - Fax:
Practice Address - Street 1:8057 WATSON RD
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-5304
Practice Address - Country:US
Practice Address - Phone:314-749-9006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004021237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor