Provider Demographics
NPI:1801028089
Name:CONSIDINE, THOMAS JOHN MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN MATTHEW
Last Name:CONSIDINE
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 1:1724 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53094-7417
Mailing Address - Country:US
Mailing Address - Phone:920-262-2282
Mailing Address - Fax:
Practice Address - Street 1:1724 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53094-7417
Practice Address - Country:US
Practice Address - Phone:920-262-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4537-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor