Provider Demographics
NPI:1922032762
Name:THOMAS CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:THOMAS CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:KLEINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-781-9987
Mailing Address - Street 1:1508 SW MAPP RD
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2446
Mailing Address - Country:US
Mailing Address - Phone:772-781-9987
Mailing Address - Fax:772-781-5384
Practice Address - Street 1:1508 SW MAPP RD
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2446
Practice Address - Country:US
Practice Address - Phone:772-781-9987
Practice Address - Fax:772-781-5384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL361657900OtherOWCP
FL70320OtherBLUE CROSS BLUE SHIELD
FL3822596OtherHEALTHSMART
FL350056451OtherRAILROAD MEDICARE
FL70320OtherBLUE CROSS BLUE SHIELD
FL350056451OtherRAILROAD MEDICARE