Provider Demographics
NPI:1669786729
Name:STETSON, THOMAS JAY (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JAY
Last Name:STETSON
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 1:224 ONEIL CT
Mailing Address - Street 2:SUITE 12
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:224 ONEIL CT
Practice Address - Street 2:SUITE 12
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7649
Practice Address - Country:US
Practice Address - Phone:814-397-6516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-01
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor