Provider Demographics
NPI:1881726131
Name:HONKA, THOMAS MARTIN (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MARTIN
Last Name:HONKA
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 1:851 W MORTON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3185
Mailing Address - Country:US
Mailing Address - Phone:559-781-2222
Mailing Address - Fax:559-781-2143
Practice Address - Street 1:851 W MORTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3185
Practice Address - Country:US
Practice Address - Phone:559-781-2222
Practice Address - Fax:559-781-2143
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0217180OtherMEDICARE PTAN