Provider Demographics
NPI:1417031188
Name:TERBILCOX, THOMAS F (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:TERBILCOX
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 1:590 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU SAC
Mailing Address - State:WI
Mailing Address - Zip Code:53578-1136
Mailing Address - Country:US
Mailing Address - Phone:608-643-4285
Mailing Address - Fax:
Practice Address - Street 1:590 4TH ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU SAC
Practice Address - State:WI
Practice Address - Zip Code:53578-1136
Practice Address - Country:US
Practice Address - Phone:608-643-4285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIT92310Medicare UPIN
WI000035209Medicare ID - Type Unspecified