Provider Demographics
NPI:1124192315
Name:TMT SOUTHWEST INC
Entity Type:Organization
Organization Name:TMT SOUTHWEST INC
Other - Org Name:ALL WEST FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TRAINA
Authorized Official - Suffix:
Authorized Official - Credentials:DC CCSP
Authorized Official - Phone:623-773-0300
Mailing Address - Street 1:13470 N 83RD AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381
Mailing Address - Country:US
Mailing Address - Phone:623-773-0300
Mailing Address - Fax:623-773-0200
Practice Address - Street 1:13470 N 83RD AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381
Practice Address - Country:US
Practice Address - Phone:623-773-0300
Practice Address - Fax:623-773-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0932130OtherBLUE CROSS BLUE SHIELD
AZ0932130OtherBLUE CROSS BLUE SHIELD