Healthcare Provider Details

I. General information

NPI: 1912462912
Provider Name (Legal Business Name): THOMAS GEORGE BRETT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MISSOURI 248 BUILDING 3 SUITE A
BRANSON MO
65616
US

IV. Provider business mailing address

800 MISSOURI 248 BUILDING 3 SUITE A
BRANSON MO
65616
US

V. Phone/Fax

Practice location:
  • Phone: 417-593-9450
  • Fax: 417-332-1982
Mailing address:
  • Phone: 417-593-9450
  • Fax: 417-332-1982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number2003006262
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: