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General NPI Number Information
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NPI Number | 1710161278
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Entity Type | Organization
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Legal Business Name | THOMAS WONG CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 116 W FOOTHILL BLVD
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City | MONROVIA
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State | CA
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Zip | 91016-2171
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Country | US
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Telephone | 626-358-5849
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Fax | 626-358-5849
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Provider Business Mailing Address
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Address Line | 116 W FOOTHILL BLVD
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City | MONROVIA
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State | CA
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Zip | 91016-2171
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Country | US
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Telephone | 626-358-5849
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Fax | 626-358-5849
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS WONG
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Credential | D.C.
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Telephone | 626-358-5849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC-29838
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC-30431
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License Number State | CA
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