Provider Demographics
NPI:1275152894
Name:THOMAS, ZACHARY B (DC)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:B
Last Name:THOMAS
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 1:214 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-3381
Mailing Address - Country:US
Mailing Address - Phone:662-323-2371
Mailing Address - Fax:
Practice Address - Street 1:214 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-3381
Practice Address - Country:US
Practice Address - Phone:662-323-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor