Healthcare Provider Details

I. General information

NPI: 1780357467
Provider Name (Legal Business Name): TNT CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 MEADE AVE
PROSSER WA
99350-1423
US

IV. Provider business mailing address

1209 MEADE AVE
PROSSER WA
99350-1423
US

V. Phone/Fax

Practice location:
  • Phone: 509-786-3637
  • Fax: 509-786-7385
Mailing address:
  • Phone: 509-786-3637
  • Fax: 509-786-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DANA MCCOLLUM
Title or Position: OFFICE MANAGER
Credential:
Phone: 509-786-3637