Provider Demographics
NPI:1053829127
Name:THOMAS, CHLOE A
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CULLOWHEE
Mailing Address - State:NC
Mailing Address - Zip Code:28723-8911
Mailing Address - Country:US
Mailing Address - Phone:704-692-4877
Mailing Address - Fax:
Practice Address - Street 1:3971 LITTLE SAVANNAH ROAD
Practice Address - Street 2:
Practice Address - City:CULLOWHEE
Practice Address - State:NC
Practice Address - Zip Code:28723
Practice Address - Country:US
Practice Address - Phone:828-227-7271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
JXN153M78561OtherANTHEM BLUECROSS