Provider Demographics
NPI:1225545676
Name:TARR CHIROPRACTIC CLINIC INC
Entity type:Organization
Organization Name:TARR CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:DELAINE
Authorized Official - Last Name:TARR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-783-5900
Mailing Address - Street 1:1301 W JOURDAN ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IL
Mailing Address - Zip Code:62448-2000
Mailing Address - Country:US
Mailing Address - Phone:618-783-5900
Mailing Address - Fax:618-783-3113
Practice Address - Street 1:1301 W JOURDAN ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IL
Practice Address - Zip Code:62448-2000
Practice Address - Country:US
Practice Address - Phone:618-783-5900
Practice Address - Fax:618-783-3113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008071111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty