Healthcare Provider Details

I. General information

NPI: 1114023066
Provider Name (Legal Business Name): THOMAS HEATH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 W MAIN ST
SALUNGA PA
17538-1127
US

IV. Provider business mailing address

14 W MAIN ST
SALUNGA PA
17538-1127
US

V. Phone/Fax

Practice location:
  • Phone: 717-530-5555
  • Fax:
Mailing address:
  • Phone: 717-530-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC003766R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: