Provider Demographics
NPI:1003968033
Name:LAHMANN, THOMAS FREDERICK
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FREDERICK
Last Name:LAHMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 STATE ROAD 13
Mailing Address - Street 2:SUITE 11
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-2989
Mailing Address - Country:US
Mailing Address - Phone:904-230-0080
Mailing Address - Fax:904-230-1040
Practice Address - Street 1:465 STATE ROAD 13
Practice Address - Street 2:SUITE 11
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259-2989
Practice Address - Country:US
Practice Address - Phone:904-230-0080
Practice Address - Fax:904-230-1040
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH-7904111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55954Medicare ID - Type Unspecified