Provider Demographics
NPI:1689888638
Name:TOMPKINS FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:TOMPKINS FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:G
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:520-572-2596
Mailing Address - Street 1:7620 N HARTMAN LN
Mailing Address - Street 2:SUITE 124-2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-8263
Mailing Address - Country:US
Mailing Address - Phone:520-572-2596
Mailing Address - Fax:520-572-6316
Practice Address - Street 1:7620 N HARTMAN LN
Practice Address - Street 2:SUITE 124-2
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-8263
Practice Address - Country:US
Practice Address - Phone:520-572-2596
Practice Address - Fax:520-572-6316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ108123Medicare ID - Type UnspecifiedINDIVIDUAL #
AZU99151Medicare UPIN
AZ108122Medicare ID - Type UnspecifiedGROUP #