Provider Demographics
NPI:1992922611
Name:GARCIA, THOMAS PETER (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PETER
Last Name:GARCIA
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:P.O BOX 224
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122
Mailing Address - Country:US
Mailing Address - Phone:970-563-1006
Mailing Address - Fax:970-563-9591
Practice Address - Street 1:800 HEARTWOOD
Practice Address - Street 2:23
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122-9381
Practice Address - Country:US
Practice Address - Phone:970-563-1006
Practice Address - Fax:970-563-9591
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4962111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC49373Medicare PIN