Provider Demographics
NPI:1952406548
Name:MYERS, THOMAS W (DC, ATC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:MYERS
Suffix:
Gender:M
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23900 STATE ROAD 54 STE 101
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-6792
Mailing Address - Country:US
Mailing Address - Phone:813-973-8883
Mailing Address - Fax:813-762-1413
Practice Address - Street 1:23900 STATE ROAD 54 SUITE 101
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-6792
Practice Address - Country:US
Practice Address - Phone:813-973-8883
Practice Address - Fax:813-762-1413
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9195111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor