Provider Demographics
NPI:1326124900
Name:LO, THOMAS K (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:K
Last Name:LO
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 1:2135 DEFENSE HWY
Mailing Address - Street 2:SUITE 1-3
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2430
Mailing Address - Country:US
Mailing Address - Phone:410-721-3338
Mailing Address - Fax:410-721-4129
Practice Address - Street 1:2135 DEFENSE HWY
Practice Address - Street 2:SUITE 1-3
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2430
Practice Address - Country:US
Practice Address - Phone:410-721-3338
Practice Address - Fax:410-721-4129
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM472TKOtherCAREFIRST
MDR7590001OtherCAREFIRST
MDR7590001OtherCAREFIRST
MDM472TKOtherCAREFIRST