Provider Demographics
NPI:1548233950
Name:DR JOHN E THOMASSY P C
Entity Type:Organization
Organization Name:DR JOHN E THOMASSY P C
Other - Org Name:THALIA CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:THOMASSY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-340-2817
Mailing Address - Street 1:4136 BONNEY ROAD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1741
Mailing Address - Country:US
Mailing Address - Phone:757-340-2817
Mailing Address - Fax:757-340-4866
Practice Address - Street 1:4136 BONNEY ROAD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1741
Practice Address - Country:US
Practice Address - Phone:757-340-2817
Practice Address - Fax:757-340-4866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000206111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2237537-00OtherU.S. DEPT. OF LABOR
VA244733OtherBLUE CROSS/BLUE SHIELD #
VAC08638Medicare PIN
VA350048760Medicare PIN