Provider Demographics
NPI:1790994705
Name:CHARLES, THOMAS H (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:H
Last Name:CHARLES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:CHARLES
Other - Middle Name:CHIROPRACTIC
Other - Last Name:HEALTH CENTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:135 MILLERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4250
Mailing Address - Country:US
Mailing Address - Phone:717-396-7755
Mailing Address - Fax:717-394-0470
Practice Address - Street 1:135 MILLERSVILLE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4250
Practice Address - Country:US
Practice Address - Phone:717-396-7755
Practice Address - Fax:717-394-0470
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003344L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor