Provider Demographics
NPI:1558575027
Name:TRAINA, THOMAS MICHAEL (DC CCSP)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:TRAINA
Suffix:
Gender:M
Credentials:DC CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0932130OtherBLUE CROSS
AZ0932130OtherBLUE CROSS