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General NPI Number Information
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NPI Number | 1306465455
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Entity Type | Organization
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Legal Business Name | TMTHREE LLC
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 12409 W INDIAN SCHOOL RD STE B210
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City | AVONDALE
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State | AZ
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Zip | 85392-9505
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Country | US
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Telephone | 602-677-0187
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Fax | 480-930-4018
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Provider Business Mailing Address
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Address Line | PO BOX 11180
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City | TEMPE
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State | AZ
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Zip | 85284-0020
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Country | US
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Telephone | 602-677-0187
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Fax |
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Authorized Official
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Title or Position | SOLE MEMEBER
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Name | THOMAS MORGAN
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Credential | DC
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Telephone | 602-680-9976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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