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General NPI Number Information
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NPI Number | 1841275963
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Entity Type | Individual
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Provider Name | JOHN THOMAS TIERNEY DC
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Gender | Male
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1295 OLD US #1 S STE F
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City | SOUTHERN PINES
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State | NC
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Zip | 28387
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Country | US
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Telephone | 910-246-2099
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Fax | 910-692-5016
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Provider Business Mailing Address
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Address Line | 1295 OLD US #1 S STE F
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City | SOUTHERN PINES
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State | NC
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Zip | 28387
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Country | US
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Telephone | 910-246-2099
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Fax | 910-692-5016
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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 | 702
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License Number State | NC
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