Provider Demographics
NPI:1760483705
Name:SELL, THOMAS PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PAUL
Last Name:SELL
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 1:475 N MAPLE RD
Mailing Address - Street 2:TRAILER 70
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1640
Mailing Address - Country:US
Mailing Address - Phone:517-442-5278
Mailing Address - Fax:517-423-8335
Practice Address - Street 1:1075 ANN ARBOR RD W
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2128
Practice Address - Country:US
Practice Address - Phone:734-454-5600
Practice Address - Fax:734-454-5696
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2013-12-30
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
MI2301008362111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1988007OtherPTAN
MIN86770001Medicare ID - Type UnspecifiedMEDICARE ID