Provider Demographics
NPI:1215225818
Name:THROM CHIROPRACTIC SC
Entity Type:Organization
Organization Name:THROM CHIROPRACTIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:THROM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-302-3066
Mailing Address - Street 1:605 S 24TH AVE
Mailing Address - Street 2:SUITE 46
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-1705
Mailing Address - Country:US
Mailing Address - Phone:715-301-1111
Mailing Address - Fax:
Practice Address - Street 1:605 S 24TH AVE
Practice Address - Street 2:SUITE 46
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-1705
Practice Address - Country:US
Practice Address - Phone:715-301-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-16
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4176-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty