Healthcare Provider Details

I. General information

NPI: 1770703084
Provider Name (Legal Business Name): TANQUE VERDE CHIROPRACTIC CLINIC P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 E TANQUE VERDE RD STE 140
TUCSON AZ
85749-8173
US

IV. Provider business mailing address

9100 E TANQUE VERDE RD STE 140
TUCSON AZ
85749-8173
US

V. Phone/Fax

Practice location:
  • Phone: 520-749-2929
  • Fax: 520-749-8391
Mailing address:
  • Phone: 520-749-2929
  • Fax: 520-749-8391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4880
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number4880
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number4880
License Number StateAZ

VIII. Authorized Official

Name: DR. MICHAEL JOSEPH STONE
Title or Position: DOCTOR
Credential: DC, DABCI
Phone: 520-749-2929