Provider Demographics
NPI:1407251143
Name:THOMAS, NATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
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 1:6801 W 121ST ST
Mailing Address - Street 2:STE 122
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2005
Mailing Address - Country:US
Mailing Address - Phone:816-699-2648
Mailing Address - Fax:
Practice Address - Street 1:6801 W 121ST ST
Practice Address - Street 2:STE 122
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2005
Practice Address - Country:US
Practice Address - Phone:816-699-2648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor