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NPI Code Detail

MEDICARE: DR. TAMARA CHRISTINA VALOVICH MCLEOD PHD, ATC

MEDICARE:  DR. TAMARA CHRISTINA VALOVICH MCLEOD  PHD, ATC
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
12255A2300XAthletic Trainer0387AZ

General Provider Information

NPI Number : 1417929340
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAMARA CHRISTINA VALOVICH MCLEOD PHD, ATC
Provider Business Mailing Address
First Line : 932 W LA JOLLA DR
Second Line :
City : TEMPE
State : AZ
Zip : 85282-4709
Country : US
Telephone Number : 480-968-5919
Fax Number : 480-219-6100
Provider Business Practice Location Address
First Line : 5850 E STILL CIR
Second Line :
City : MESA
State : AZ
Zip : 85206-3618
Country : US
Telephone Number : 480-219-6035
Fax Number : 480-219-6100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2006
Last Update Date : 07/08/2007

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Directions to “ DR. TAMARA CHRISTINA VALOVICH MCLEOD PHD, ATC” Practice Location

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