Provider Demographics
NPI:1013038660
Name:THOMAS K. LO, D.C., M.A., LLC
Entity Type:Organization
Organization Name:THOMAS K. LO, D.C., M.A., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-721-3338
Mailing Address - Street 1:2135 DEFENSE HWY
Mailing Address - Street 2:SUITE 1-3
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2430
Mailing Address - Country:US
Mailing Address - Phone:410-721-3338
Mailing Address - Fax:410-721-4129
Practice Address - Street 1:2135 DEFENSE HWY
Practice Address - Street 2:SUITE 1-3
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2430
Practice Address - Country:US
Practice Address - Phone:410-721-3338
Practice Address - Fax:410-721-4129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MHR759 0001OtherCAREFIRST
MDM472TKOtherCAREFIRST
MDM472Medicare PIN
MHR759 0001OtherCAREFIRST