Healthcare Provider Details

I. General information

NPI: 1760539134
Provider Name (Legal Business Name): TOMAS E. STANGEL D.C., DACNB, FACFN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6106 SHALLOWFORD RD. SUITE 104
CHATTANOOGA TN
37421-9994
US

IV. Provider business mailing address

6106 SHALLOWFORD RD. SUITE 104
CHATTANOOGA, TN TN
37421-9994
US

V. Phone/Fax

Practice location:
  • Phone: 423-468-3072
  • Fax: 423-468-3164
Mailing address:
  • Phone: 423-468-3072
  • Fax: 423-468-3164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number778
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number778
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: