Provider Demographics
NPI:1053529958
Name:HANDS ON HEALTHCARE
Entity type:Organization
Organization Name:HANDS ON HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-776-8864
Mailing Address - Street 1:722 N MONTEZUMA ST
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-2002
Mailing Address - Country:US
Mailing Address - Phone:928-776-8864
Mailing Address - Fax:928-776-0964
Practice Address - Street 1:722 N MONTEZUMA ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-2002
Practice Address - Country:US
Practice Address - Phone:928-776-8864
Practice Address - Fax:928-776-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7374111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ=========OtherTAX ID NO.
AZZ75612Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.