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1811 George Washington Memorial Hwy, Gloucester Point, VA 23062-2220 | |
(757) 202-2960 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 1811 George Washington Memorial Hwy, Gloucester Point, Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1235602426 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Michael A Tiso |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1811281561 PECOS PAC ID: 9234440405 Enrollment ID: I20150616000360 |
Mailing Address | Practice Location Address |
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1811 George Washington Memorial Hwy, Gloucester Point, VA 23062-2220 Ph: (804) 684-5196 | 1811 George Washington Memorial Hwy, Gloucester Point, VA 23062-2220 Ph: (757) 202-2960 |