Healthcare Provider Details

I. General information

NPI: 1407260425
Provider Name (Legal Business Name): TANNER WAYNE COLEMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S WEST END ST
SPRINGDALE AR
72764-5239
US

IV. Provider business mailing address

1000 S WEST END ST
SPRINGDALE AR
72764-5239
US

V. Phone/Fax

Practice location:
  • Phone: 479-751-8686
  • Fax: 479-751-6022
Mailing address:
  • Phone: 479-751-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16374
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number16374
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2015005071
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: