Provider Demographics
NPI:1255391439
Name:SAWYER, THOMAS RALPH (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:RALPH
Last Name:SAWYER
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 1:564 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1505
Mailing Address - Country:US
Mailing Address - Phone:419-543-0464
Mailing Address - Fax:419-524-4681
Practice Address - Street 1:564 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1505
Practice Address - Country:US
Practice Address - Phone:419-524-4681
Practice Address - Fax:419-524-4681
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0432661Medicare UPIN