Provider Demographics
NPI:1831547371
Name:ROBERT B THOMA DC PC
Entity type:Organization
Organization Name:ROBERT B THOMA DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:THOMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-481-5444
Mailing Address - Street 1:2244 SUNSTATES CT
Mailing Address - Street 2:#104
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1552
Mailing Address - Country:US
Mailing Address - Phone:757-481-5444
Mailing Address - Fax:
Practice Address - Street 1:2244 SUNSTATES CT
Practice Address - Street 2:#104
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-1552
Practice Address - Country:US
Practice Address - Phone:757-481-5444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty