Healthcare Provider Details

I. General information

NPI: 1275152894
Provider Name (Legal Business Name): ZACHARY B THOMAS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 VIRGINIA AVE
COLLEGE PARK GA
30337-2824
US

IV. Provider business mailing address

1624 VIRGINIA AVE
COLLEGE PARK GA
30337-2824
US

V. Phone/Fax

Practice location:
  • Phone: 404-781-2225
  • Fax: 404-781-2226
Mailing address:
  • Phone: 404-781-2225
  • Fax: 404-781-2226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR011405
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: