Provider Demographics
NPI:1710093737
Name:VENTI, THOMAS JOHN (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOHN
Last Name:VENTI
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 1:78 MCKAY ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3031
Mailing Address - Country:US
Mailing Address - Phone:978-927-2270
Mailing Address - Fax:978-927-3255
Practice Address - Street 1:78 MCKAY ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-3031
Practice Address - Country:US
Practice Address - Phone:978-927-2270
Practice Address - Fax:978-927-3255
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA866111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35596Medicare ID - Type Unspecified