Provider Demographics
NPI:1750490793
Name:COLE, THOMAS M (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:COLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 NEW ORLEANS RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-4743
Mailing Address - Country:US
Mailing Address - Phone:843-842-7575
Mailing Address - Fax:843-842-7676
Practice Address - Street 1:14 NEW ORLEANS RD
Practice Address - Street 2:SUITE 4
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-4743
Practice Address - Country:US
Practice Address - Phone:843-842-7575
Practice Address - Fax:843-842-7676
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC350040057OtherRAILROAD MEDICARE
SC571055885OtherTAX ID
SCCH1726Medicaid
SC350040057OtherRAILROAD MEDICARE
SC571055885OtherTAX ID