Provider Demographics
NPI:1578548061
Name:HORNAMAN, THOMAS J (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:HORNAMAN
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 1:107 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16438-1011
Mailing Address - Country:US
Mailing Address - Phone:814-438-7242
Mailing Address - Fax:814-438-7829
Practice Address - Street 1:107 N MAIN ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:PA
Practice Address - Zip Code:16438-1011
Practice Address - Country:US
Practice Address - Phone:814-438-7242
Practice Address - Fax:814-438-7829
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005362L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA419266OtherHIGHMARK BC/BS
PA1012222940001Medicaid
PA1012222940001Medicaid
PA419266S51Medicare ID - Type Unspecified