Provider Demographics
NPI:1538493945
Name:WACHTMANN, THOMAS B (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:B
Last Name:WACHTMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3130 PRICETOWN RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-8750
Mailing Address - Country:US
Mailing Address - Phone:610-944-5000
Mailing Address - Fax:610-944-9018
Practice Address - Street 1:3130 PRICETOWN RD
Practice Address - Street 2:SUITE H
Practice Address - City:FLEETWOOD
Practice Address - State:PA
Practice Address - Zip Code:19522-8750
Practice Address - Country:US
Practice Address - Phone:610-944-5000
Practice Address - Fax:610-944-9018
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2011-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADC006523L111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition