Provider Demographics
NPI:1427766724
Name:SCRIMO, THOMAS JAMES (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JAMES
Last Name:SCRIMO
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 1:346 WEATHERSTONE PL
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-4473
Mailing Address - Country:US
Mailing Address - Phone:678-414-8958
Mailing Address - Fax:
Practice Address - Street 1:859 MIMOSA BLVD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-4436
Practice Address - Country:US
Practice Address - Phone:678-414-8958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor