Provider Demographics
NPI:1851746747
Name:NIEMELA, THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:NIEMELA
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 1:1401 S WALTON BLVD STE 25
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-6139
Mailing Address - Country:US
Mailing Address - Phone:479-208-6766
Mailing Address - Fax:479-435-7120
Practice Address - Street 1:1401 S WALTON BLVD STE 25
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6139
Practice Address - Country:US
Practice Address - Phone:479-208-6766
Practice Address - Fax:479-435-7120
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16124111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor