Healthcare Provider Details

I. General information

NPI: 1083649453
Provider Name (Legal Business Name): JOEL D VRANNA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 S 72ND ST SUITE A
TACOMA WA
98408-1238
US

IV. Provider business mailing address

1702 S 72ND ST SUITE A
TACOMA WA
98408-1238
US

V. Phone/Fax

Practice location:
  • Phone: 253-474-0677
  • Fax: 253-474-3540
Mailing address:
  • Phone: 253-474-0677
  • Fax: 253-474-3540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00001930
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: