Provider Demographics
NPI:1043843923
Name:MEDLIN, THOMAS IAN (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:IAN
Last Name:MEDLIN
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 1:469 BELCHER RD
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-8368
Mailing Address - Country:US
Mailing Address - Phone:954-513-8381
Mailing Address - Fax:
Practice Address - Street 1:140 SAGE CREEK WAY
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-0957
Practice Address - Country:US
Practice Address - Phone:864-848-0640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor