Provider Demographics
NPI:1912989500
Name:TENNANT, MARC D (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:D
Last Name:TENNANT
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:PO BOX 8488
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66608-0488
Mailing Address - Country:US
Mailing Address - Phone:785-232-8614
Mailing Address - Fax:785-232-6915
Practice Address - Street 1:2707 N. TOPEKA AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66617
Practice Address - Country:US
Practice Address - Phone:785-232-8614
Practice Address - Fax:785-232-6915
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor