Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 1109 | OH |
NPI | 1427117837 |
---|---|
Provider Name | Dr. Thomas Anthony Thomas |
First Address | Brookfield, OH 44403-9758 |
Second Address | Youngstown, OH 44502-2504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |