# TUCSON CONCUSSION CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114306917
- **Authorized official:** DR. HIRSCH HANDMAKER M.D. (CHAIRMAN/CEO)
- **Authorized official phone:** (310) 259-2090

## Contact information

- **Practice address:** 5199 E FARNESS DR, SUITE 101, TUCSON, AZ 85712-2134
- **Practice address phone:** (844) 822-6824
- **Mailing address:** 5199 EAST FARNESS, SUITE 101, TUCSON, AZ 85712-2134
- **Mailing address phone:** (520) 620-9100
- **Mailing address fax:** (844) 822-6824

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 152WV0400X | Vision Therapy Optometrist | — | NULL | — |
| 152WV0400X | Vision Therapy Optometrist | — | — | — |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 05/26/2015
- **Last updated:** 11/25/2015