MEDICARE: ROBERT TONTI DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	6921	TX

General Provider Information

NPI Number	:	1114586799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT TONTI DC

Provider Business Mailing Address
First Line	:	9117 TRAIL BLAZER DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76131-3119
Country	:	US
Telephone Number	:	817-946-3413
Fax Number	:

Provider Business Practice Location Address
First Line	:	3017 FM 718
Second Line	:
City	:	NEWARK
State	:	TX
Zip	:	76071-4001
Country	:	US
Telephone Number	:	817-956-3413
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2019
Last Update Date	:	06/07/2019

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