Provider Demographics
NPI:1205023504
Name:NATHAN VARANO DC PC
Entity Type:Organization
Organization Name:NATHAN VARANO DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VARANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-318-4435
Mailing Address - Street 1:4626 E FORT LOWELL RD
Mailing Address - Street 2:STE. M
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1184
Mailing Address - Country:US
Mailing Address - Phone:520-318-4435
Mailing Address - Fax:520-326-0490
Practice Address - Street 1:4626 E FORT LOWELL RD
Practice Address - Street 2:STE. M
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1184
Practice Address - Country:US
Practice Address - Phone:520-318-4435
Practice Address - Fax:520-326-0490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ69141Medicare PIN