Provider Demographics
NPI:1639242688
Name:TINLIN, JOLENE MARIE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:JOLENE
Middle Name:MARIE
Last Name:TINLIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 E SAN CARLOS WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-3044
Mailing Address - Country:US
Mailing Address - Phone:480-802-4878
Mailing Address - Fax:
Practice Address - Street 1:1059 E BROADWAY RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-2153
Practice Address - Country:US
Practice Address - Phone:480-833-8003
Practice Address - Fax:480-962-6384
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-02942P174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist