Provider Demographics
NPI:1457383184
Name:TOMAR, VINCENT M (DC)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:M
Last Name:TOMAR
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 1:8178 MALL RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1414
Mailing Address - Country:US
Mailing Address - Phone:859-746-2222
Mailing Address - Fax:859-746-2131
Practice Address - Street 1:8178 MALL RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1414
Practice Address - Country:US
Practice Address - Phone:859-746-2222
Practice Address - Fax:859-746-2131
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6072001Medicare ID - Type Unspecified
KYU57587Medicare UPIN