Provider Demographics
NPI:1295857308
Name:HEWITT, THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:HEWITT
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 1:2244 ANDOVER WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7053
Mailing Address - Country:US
Mailing Address - Phone:843-433-6001
Mailing Address - Fax:
Practice Address - Street 1:1313 LONG GROVE DR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-9463
Practice Address - Country:US
Practice Address - Phone:843-433-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29711111N00000X
SC4413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor