Provider Demographics
NPI:1114117835
Name:DANIEL V TOMINELLO M.S., D.C., P.C.
Entity Type:Organization
Organization Name:DANIEL V TOMINELLO M.S., D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:TOMINELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-548-3333
Mailing Address - Street 1:1632 MILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-1040
Mailing Address - Country:US
Mailing Address - Phone:248-765-2587
Mailing Address - Fax:
Practice Address - Street 1:1632 MILLARD AVE
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1040
Practice Address - Country:US
Practice Address - Phone:248-765-2587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N85760Medicare PIN