Provider Demographics
NPI:1043385339
Name:BURNS, THOMAS JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JAMES
Last Name:BURNS
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 1:8187 RHODE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-3279
Mailing Address - Country:US
Mailing Address - Phone:586-731-1188
Mailing Address - Fax:586-731-1184
Practice Address - Street 1:8187 RHODE DR
Practice Address - Street 2:SUITE A
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-3279
Practice Address - Country:US
Practice Address - Phone:586-731-1188
Practice Address - Fax:586-731-1184
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU16664Medicare UPIN
MI0F35015Medicare ID - Type Unspecified