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Organization

SPORT INSTITUTE OF TUCSON PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TY HOWARD ENDEAN D.O. (DIRECTOR/OWNER)
(520) 618-5500
Entity
Organization

Contact information

Practice address
6369 E TANQUE VERDE RD, TUCSON, AZ 85715-3850
(520) 618-5500
(520) 618-5944
Mailing address
6369 E TANQUE VERDE RD, TUCSON, AZ 85715-3850
(520) 618-5500
(520) 618-5944

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3953
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11334734
CAQH
AZ
Enumeration date
05/02/2006
Last updated
08/27/2013
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