Provider Demographics
NPI:1023704459
Name:HARTLINE, TORI BOTTIGLIONE (DC, MS)
Entity type:Individual
Prefix:DR
First Name:TORI
Middle Name:BOTTIGLIONE
Last Name:HARTLINE
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 N COLONY BLVD
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-1300
Mailing Address - Country:US
Mailing Address - Phone:480-773-0875
Mailing Address - Fax:
Practice Address - Street 1:4811 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4694
Practice Address - Country:US
Practice Address - Phone:469-249-2623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14878111NN0400X, 111NN1001X, 111NR0400X, 111NX0800X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0800XChiropractic ProvidersChiropractorOrthopedic