Provider Demographics
NPI:1588997381
Name:COMPREHENSIVE OCCUPATIONAL HEALTH SERVICES OF TRI-CITIES, PLLC
Entity type:Organization
Organization Name:COMPREHENSIVE OCCUPATIONAL HEALTH SERVICES OF TRI-CITIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURILIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-735-6616
Mailing Address - Street 1:320 N JOHNSON ST
Mailing Address - Street 2:SUITE 850
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2771
Mailing Address - Country:US
Mailing Address - Phone:509-735-4141
Mailing Address - Fax:509-735-3434
Practice Address - Street 1:320 N JOHNSON ST
Practice Address - Street 2:SUITE 850
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2771
Practice Address - Country:US
Practice Address - Phone:509-735-4141
Practice Address - Fax:509-735-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007683364SX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SX0106XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOccupational HealthGroup - Single Specialty