Provider Demographics
NPI:1912050188
Name:HARMODY, THOMAS ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALAN
Last Name:HARMODY
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 1:2006 32ND AVE
Mailing Address - Street 2:STE A
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2430
Mailing Address - Country:US
Mailing Address - Phone:772-778-2225
Mailing Address - Fax:772-778-0304
Practice Address - Street 1:2006 32ND AVE
Practice Address - Street 2:STE A
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2430
Practice Address - Country:US
Practice Address - Phone:772-778-2225
Practice Address - Fax:772-778-0304
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64016OtherBCBS
V06074Medicare UPIN
FL64016Medicare ID - Type Unspecified