Basic Information
Provider Information
NPI: 1265725485
EntityType: 2
ReplacementNPI:  
OrganizationName: TM HEALTHCARE LLC
LastName:  
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Mailing Information
Address1: PO BOX 2954
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850622954
CountryCode: US
TelephoneNumber: 6028895833
FaxNumber: 6028895834
Practice Location
Address1: 12409 W INDIAN SCHOOL RD SUITE B-210
Address2:  
City: AVONDALE
State: AZ
PostalCode: 85323
CountryCode: US
TelephoneNumber: 6028895833
FaxNumber: 6028895834
Other Information
ProviderEnumerationDate: 05/20/2011
LastUpdateDate: 03/23/2012
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: MORGAN
AuthorizedOfficialFirstName: THOMAS
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AuthorizedOfficialTitleorPosition: MANAGER
AuthorizedOfficialTelephone: 6028895833
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: DC
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X  N193200000X MULTI-SPECIALTY GROUPChiropractic ProvidersChiropractor 
171M00000X  N193200000X MULTI-SPECIALTY GROUPOther Service ProvidersCase Manager/Care Coordinator 
363LF0000X  Y193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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