Provider Demographics
NPI:1689874984
Name:BOCH, THOMAS ALFRED (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALFRED
Last Name:BOCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:TOM
Other - Middle Name:
Other - Last Name:BOCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:35 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-1751
Mailing Address - Country:US
Mailing Address - Phone:717-790-9043
Mailing Address - Fax:717-790-2279
Practice Address - Street 1:35 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1751
Practice Address - Country:US
Practice Address - Phone:717-790-9043
Practice Address - Fax:717-790-2279
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 0001567L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor