Provider Demographics
NPI:1598925190
Name:THOMASON, TOMMY DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:DOUGLAS
Last Name:THOMASON
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 1:118 PIEDMONT HWY
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-9102
Mailing Address - Country:US
Mailing Address - Phone:864-845-7060
Mailing Address - Fax:
Practice Address - Street 1:118 PIEDMONT HWY
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-9102
Practice Address - Country:US
Practice Address - Phone:864-845-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor