Provider Demographics
NPI:1598807042
Name:KRACHT, THOMAS F JR (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:KRACHT
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3999 COMMONS DRIVE WEST
Mailing Address - Street 2:SUITE C
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541
Mailing Address - Country:US
Mailing Address - Phone:850-654-6917
Mailing Address - Fax:850-654-9459
Practice Address - Street 1:3999 COMMONS DRIVE WEST
Practice Address - Street 2:SUITE C
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541
Practice Address - Country:US
Practice Address - Phone:850-654-6917
Practice Address - Fax:850-654-9459
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLCH6571111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
22847Medicare UPIN