Provider Demographics
NPI:1114306917
Name:TUCSON CONCUSSION CENTER LLC
Entity type:Organization
Organization Name:TUCSON CONCUSSION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HIRSCH
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-259-2090
Mailing Address - Street 1:5199 EAST FARNESS
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2134
Mailing Address - Country:US
Mailing Address - Phone:520-620-9100
Mailing Address - Fax:844-822-6824
Practice Address - Street 1:5199 E FARNESS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2134
Practice Address - Country:US
Practice Address - Phone:844-822-6824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty