Provider Demographics
NPI:1417169418
Name:TYGIEL PT PC
Entity Type:Organization
Organization Name:TYGIEL PT PC
Other - Org Name:TYGIEL PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TYRASANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-296-8513
Mailing Address - Street 1:6606 E CARONDELET DRIVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2119
Mailing Address - Country:US
Mailing Address - Phone:520-296-8513
Mailing Address - Fax:520-296-0075
Practice Address - Street 1:6606 E. CARONDELET DRIVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2119
Practice Address - Country:US
Practice Address - Phone:520-296-8513
Practice Address - Fax:520-296-0075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0415261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ27913OtherMEDI GRP PIN