Provider Demographics
NPI:1619485745
Name:EDDINS, THOMAS ALLEN III (LAC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ALLEN
Last Name:EDDINS
Suffix:III
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3574 OLD US HIGHWAY 421
Mailing Address - Street 2:
Mailing Address - City:VILAS
Mailing Address - State:NC
Mailing Address - Zip Code:28692-9066
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:232 FURMAN RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5050
Practice Address - Country:US
Practice Address - Phone:828-773-5032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC413171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist