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NPI 1801959820

NPI 1801959820 : NEIL M THOMAS D.C. : OWASSO, OK

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General NPI Number Information
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    NPI Number           |    1801959820
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    Entity Type          |    Individual 
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    Provider Name        |    NEIL M THOMAS D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/19/2006
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    Last Update Date     |    09/28/2017
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Provider Practice Location Address
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    Address Line         |    9500 N 129TH EAST AVE STE 109
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    City                 |    OWASSO
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    State                |    OK
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    Zip                  |    74055-5376
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    Country              |    US
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    Telephone            |    918-376-4117
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    Fax                  |    918-376-4127
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Provider Business Mailing Address
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    Address Line         |    9500 N 129TH EAST AVE STE 109
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    City                 |    OWASSO
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    State                |    OK
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    Zip                  |    74055-5376
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    Country              |    US
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    Telephone            |    918-376-4117
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    Fax                  |    918-376-4127
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    4112
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    License Number State |    OK
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