Provider Demographics
NPI:1356624431
Name:TARNICK WELLNESS PLLC
Entity type:Organization
Organization Name:TARNICK WELLNESS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:TARNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-625-4288
Mailing Address - Street 1:4705 E CAREFREE HWY STE 116A
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-4743
Mailing Address - Country:US
Mailing Address - Phone:480-625-4288
Mailing Address - Fax:480-566-0250
Practice Address - Street 1:4705 E CAREFREE HWY STE 116A
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-4743
Practice Address - Country:US
Practice Address - Phone:480-625-4288
Practice Address - Fax:480-566-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-24
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8144111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ149381OtherMEDICARE PTAN