Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 15716 | CA |
NPI | 1003948134 |
---|---|
Provider Name | Dr. Dane Stuart Thomas |
First Address | Lancaster, CA 93535-3861 |
Second Address | Lancaster, CA 93535-3861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/07/2007 |