Provider Demographics
NPI:1316580079
Name:YURCIK, RAYMOND (CH LMT)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:YURCIK
Suffix:
Gender:M
Credentials:CH LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 E PIMA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3674
Mailing Address - Country:US
Mailing Address - Phone:520-444-7201
Mailing Address - Fax:
Practice Address - Street 1:5405 E PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3674
Practice Address - Country:US
Practice Address - Phone:520-444-7201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist