Healthcare Provider Details

I. General information

NPI: 1013986678
Provider Name (Legal Business Name): THOMAS TUMBARELLO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SANDY PLAINS RD STE A 8
MARIETTA GA
30066-6370
US

IV. Provider business mailing address

700 SANDY PLAINS RD STE A 8
MARIETTA GA
30066-6370
US

V. Phone/Fax

Practice location:
  • Phone: 678-355-9090
  • Fax:
Mailing address:
  • Phone: 678-355-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR006645
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: