Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC009750 | PA |
NPI | 1134318165 |
---|---|
Provider Name | Max Dean Thomas |
First Address | Mc Murray, PA 15317-2957 |
Second Address | Mc Murray, PA 15317-2957 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2007 |
Last Update Date | 06/05/2010 |