Provider Demographics
NPI:1497900492
Name:DICK, JOSHUA THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:THOMAS
Last Name:DICK
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 1:778 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1262
Mailing Address - Country:US
Mailing Address - Phone:740-474-5352
Mailing Address - Fax:740-474-5730
Practice Address - Street 1:778 N COURT ST
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1262
Practice Address - Country:US
Practice Address - Phone:740-474-5352
Practice Address - Fax:740-474-5730
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor