Healthcare Provider Details

I. General information

NPI: 1386016665
Provider Name (Legal Business Name): TYLER T LANNING D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2015
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 S LAKEMAN DR STE D
BELLBROOK OH
45305-2315
US

IV. Provider business mailing address

2011 S LAKEMAN DR STE D
BELLBROOK OH
45305-2315
US

V. Phone/Fax

Practice location:
  • Phone: 937-310-1410
  • Fax: 937-310-1406
Mailing address:
  • Phone: 937-310-1410
  • Fax: 937-310-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4568
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4568
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberOH-04568
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number4568
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number4568
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number4568
License Number StateOH
# 7
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4568
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: