Basic Information
| Provider Information | |||||||||
| NPI: | 1134318165 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | MAX | ||||||||
| MiddleName: | DEAN | ||||||||
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| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3540 WASHINGTON RD | ||||||||
| Address2: | |||||||||
| City: | MC MURRAY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153172957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249410707 | ||||||||
| FaxNumber: | 7249417772 | ||||||||
| Practice Location | |||||||||
| Address1: | 3540 WASHINGTON RD | ||||||||
| Address2: | |||||||||
| City: | MC MURRAY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153172957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249410707 | ||||||||
| FaxNumber: | 7249417772 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2007 | ||||||||
| LastUpdateDate: | 05/06/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111NR0400X | DC009750 | PA | Y | Chiropractic Providers | Chiropractor | Rehabilitation |
No ID Information.