Provider Demographics
NPI:1891840898
Name:MONAGHAN, THOMAS A (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:MONAGHAN
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 1:3402 BATTLEGROUND AVE # B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2404
Mailing Address - Country:US
Mailing Address - Phone:336-545-1515
Mailing Address - Fax:
Practice Address - Street 1:3402 BATTLEGROUND AVE # B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2404
Practice Address - Country:US
Practice Address - Phone:336-545-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1691111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890846GMedicaid
NC890846GMedicaid
190355Medicare UPIN