Provider Demographics
NPI:1851361034
Name:TROMBLEY, THOMAS JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:TROMBLEY
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:PO BOX 706
Mailing Address - Street 2:
Mailing Address - City:PINCONNING
Mailing Address - State:MI
Mailing Address - Zip Code:48650-0706
Mailing Address - Country:US
Mailing Address - Phone:989-879-8133
Mailing Address - Fax:989-879-8133
Practice Address - Street 1:1948 N HURON RD
Practice Address - Street 2:
Practice Address - City:PINCONNING
Practice Address - State:MI
Practice Address - Zip Code:48650-7909
Practice Address - Country:US
Practice Address - Phone:989-879-8133
Practice Address - Fax:989-879-8133
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4458898Medicaid
MI4458898Medicaid
MIU80339Medicare UPIN