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General NPI Number Information
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NPI Number | 1770838625
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Entity Type | Organization
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Legal Business Name | THOMAS C. D'AMICO, D.C.P.A.
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 07/17/2012
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Provider Practice Location Address
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Address Line | 8854 W STATE ROAD 84
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City | DAVIE
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State | FL
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Zip | 33324-4455
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Country | US
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Telephone | 954-474-9995
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Fax | 954-424-7874
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Provider Business Mailing Address
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Address Line | 8854 W STATE ROAD 84
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City | DAVIE
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State | FL
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Zip | 33324-4455
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Country | US
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Telephone | 954-474-9995
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Fax | 954-424-7874
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS C D'AMICO
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Credential | DC
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Telephone | 954-474-9995
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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 | CH0005243
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License Number State | FL
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