Provider Demographics
NPI:1740232453
Name:TOMOI, THOMAS K (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:K
Last Name:TOMOI
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 1:713 W 27TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4412
Mailing Address - Country:US
Mailing Address - Phone:308-632-2255
Mailing Address - Fax:308-632-2328
Practice Address - Street 1:713 W 27TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4412
Practice Address - Country:US
Practice Address - Phone:308-632-2255
Practice Address - Fax:308-632-2328
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09787OtherBLUE CROSS BLUE SHIELD
NE22700OtherMIDLAND CHOICE
NE47074571100Medicaid
NE274032Medicare ID - Type Unspecified
NE47074571100Medicaid