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General NPI Number Information
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NPI Number | 1063628790
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Entity Type | Individual
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Provider Name | TANA MARIA NAZAR D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4800 DERRY ST
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City | HARRISBURG
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State | PA
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Zip | 17111-3440
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Country | US
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Telephone | 717-564-1550
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Fax | 717-561-1744
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Provider Business Mailing Address
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Address Line | 4802 DERRY ST
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City | HARRISBURG
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State | PA
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Zip | 17111-3440
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Country | US
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Telephone | 717-561-2247
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Fax | 717-561-1744
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC006912L
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License Number State | PA
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