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General NPI Number Information
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NPI Number | 1437709110
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Entity Type | Organization
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Legal Business Name | MIAMI VALLEY SPINE AND JOINT LLC
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 09/16/2019
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Provider Practice Location Address
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Address Line | 2011 S LAKEMAN DR STE D
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City | BELLBROOK
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State | OH
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Zip | 45305-2315
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Country | US
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Telephone | 937-310-1410
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Fax | 937-310-1406
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Provider Business Mailing Address
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Address Line | 2011 S LAKEMAN DR STE D
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City | BELLBROOK
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State | OH
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Zip | 45305-2315
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Country | US
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Telephone | 937-310-1410
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Fax | 937-310-1406
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. TYLER T LANNING
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Credential | DC
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Telephone | 937-310-1410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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