Provider Demographics
NPI:1427189067
Name:THOMAS, SCOTT STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:STEVEN
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 1:5770 S MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2982
Mailing Address - Country:US
Mailing Address - Phone:248-922-3288
Mailing Address - Fax:248-922-3290
Practice Address - Street 1:5770 S MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2982
Practice Address - Country:US
Practice Address - Phone:248-922-3288
Practice Address - Fax:248-922-3290
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor