Provider Demographics
NPI:1780704106
Name:MANIDIS, THOMAS MORE (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MORE
Last Name:MANIDIS
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 1:330 JACKSONVILLE RD APT 7-309
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-6410
Mailing Address - Country:US
Mailing Address - Phone:561-703-7984
Mailing Address - Fax:954-957-7040
Practice Address - Street 1:2162 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1740
Practice Address - Country:US
Practice Address - Phone:215-322-9400
Practice Address - Fax:954-957-7040
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8425111N00000X
PADC011317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH8425OtherSTATE LICENSE NUMBER
PADC011317OtherDC LICENSE
FL88507OtherOUT OF NETWORK BCBS PROVI
FLCH8425OtherSTATE LICENSE NUMBER