=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437466133
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THOMAS H SAWYER, A PROFESSIONAL CORP.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2010
-----------------------------------------------------
Last Update Date | 09/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 845 FOOTHILL BLVD
-----------------------------------------------------
City | LA CANADA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-952-7173
-----------------------------------------------------
Fax | 818-952-2403
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 845 FOOTHILL BLVD.
-----------------------------------------------------
City | LA CANADA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-952-7173
-----------------------------------------------------
Fax | 818-952-2403
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | THOMAS H SAWYER
-----------------------------------------------------
Credential | D.C
-----------------------------------------------------
Telephone | 818-952-7173
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC15372
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------