Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4151 | AZ |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 4151 | AZ |
NPI | 1215230198 |
---|---|
Provider Name | Mr. Thomas W. Schrimsher |
First Address | Kingman, AZ 86409-3669 |
Second Address | Kingman, AZ 86409-3669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2010 |
Last Update Date | 22/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T41699 | (02) | AZ |