Provider Demographics
NPI:1639409667
Name:THOMAS CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:THOMAS CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-283-5904
Mailing Address - Street 1:201 S DUFFY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-9103
Mailing Address - Country:US
Mailing Address - Phone:724-283-5904
Mailing Address - Fax:724-283-6769
Practice Address - Street 1:201 S DUFFY RD
Practice Address - Street 2:SUITE A
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-9103
Practice Address - Country:US
Practice Address - Phone:724-283-5904
Practice Address - Fax:724-283-6769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-14
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008911111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1427037324OtherINDIVIDUAL NPI
PA1427037324OtherINDIVIDUAL NPI