Provider Demographics
NPI:1962591495
Name:TUZZOLINO, THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:TUZZOLINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 E GELDING DR
Mailing Address - Street 2:# D101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6983
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8417 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3917
Practice Address - Country:US
Practice Address - Phone:480-946-3399
Practice Address - Fax:480-946-2559
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZV04414Medicare UPIN
AZ102037Medicare ID - Type Unspecified