Healthcare Provider Details

I. General information

NPI: 1730238734
Provider Name (Legal Business Name): TLC CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 W RANDOLPH CIR
TALLAHASSEE FL
32308-3349
US

IV. Provider business mailing address

487 E TENNESSEE ST STE 3
TALLAHASSEE FL
32301-7627
US

V. Phone/Fax

Practice location:
  • Phone: 850-216-1966
  • Fax:
Mailing address:
  • Phone: 850-222-5700
  • Fax: 850-222-8585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY SCOTT ISEMAN
Title or Position: OWNER PS
Credential: D.C.
Phone: 850-222-5700