Healthcare Provider Details

I. General information

NPI: 1952629206
Provider Name (Legal Business Name): THOMAS GEORGE EYRICH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 W 86TH ST SUITE 220
INDIANAPOLIS IN
46260-2050
US

IV. Provider business mailing address

1717 W 86TH ST SUITE 220
INDIANAPOLIS IN
46260-2050
US

V. Phone/Fax

Practice location:
  • Phone: 317-872-8684
  • Fax: 317-872-1571
Mailing address:
  • Phone: 317-872-8684
  • Fax: 317-872-1571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08002017A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: