Provider Demographics
NPI:1295093540
Name:TENER, DAVID RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RYAN
Last Name:TENER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 ASHBOROUGH CIR SE APT H
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6912
Mailing Address - Country:US
Mailing Address - Phone:516-695-2374
Mailing Address - Fax:
Practice Address - Street 1:1350 WOOTEN LAKE RD NW STE 103
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-1346
Practice Address - Country:US
Practice Address - Phone:770-974-7470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO08979111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition