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General NPI Number Information
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NPI Number | 1376660688
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Entity Type | Organization
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Legal Business Name | DR. STEVE TENCER
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 384 GOODMAN RD E SUITE 162
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9522
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Country | US
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Telephone | 662-393-8500
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Fax | 662-393-9994
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Provider Business Mailing Address
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Address Line | 1941 GOODMAN RD WEST SUITE 101
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City | HORN LAKE
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State | MS
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Zip | 38637
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Country | US
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Telephone | 662-393-8500
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Fax | 662-393-9994
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. STEVE TENCER
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Credential | DC
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Telephone | 662-393-8500
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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 | 1069
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 714
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License Number State | MS
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