Provider Demographics
NPI:1194994194
Name:THOMAS TUMBARELLO DC PC
Entity type:Organization
Organization Name:THOMAS TUMBARELLO DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMBARELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-355-9090
Mailing Address - Street 1:700 SANDY PLAINS RD STE A8
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-6392
Mailing Address - Country:US
Mailing Address - Phone:678-355-9090
Mailing Address - Fax:678-354-3691
Practice Address - Street 1:700 SANDY PLAINS RD STE A8
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-6392
Practice Address - Country:US
Practice Address - Phone:678-355-9090
Practice Address - Fax:678-354-3691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6942Medicare UPIN