Provider Demographics
NPI:1548564818
Name:ARCILA, TYRONE (PERSONAL TRAINER)
Entity Type:Individual
Prefix:
First Name:TYRONE
Middle Name:
Last Name:ARCILA
Suffix:
Gender:M
Credentials:PERSONAL TRAINER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-7936
Mailing Address - Country:US
Mailing Address - Phone:719-477-6870
Mailing Address - Fax:719-477-1483
Practice Address - Street 1:1775 S 8TH ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-7936
Practice Address - Country:US
Practice Address - Phone:719-477-6870
Practice Address - Fax:719-477-1483
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer