Provider Demographics
NPI:1003948134
Name:THOMAS, DANE STUART (DC)
Entity Type:Individual
Prefix:DR
First Name:DANE
Middle Name:STUART
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44339 CHALLENGER WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-3861
Mailing Address - Country:US
Mailing Address - Phone:661-945-4577
Mailing Address - Fax:
Practice Address - Street 1:44339 CHALLENGER WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-3861
Practice Address - Country:US
Practice Address - Phone:661-945-4577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor