Provider Demographics
NPI:1104851070
Name:THOMAS, KAREN WATERS (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:WATERS
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:REID
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:215 W POINSETT ST
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1945
Mailing Address - Country:US
Mailing Address - Phone:864-877-5795
Mailing Address - Fax:864-877-5795
Practice Address - Street 1:215 W POINSETT ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1945
Practice Address - Country:US
Practice Address - Phone:864-877-5795
Practice Address - Fax:864-877-5795
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC570956580Medicare UPIN
SCT837484333Medicare ID - Type Unspecified