MEDICARE: CHRISTOPHER THOMA DC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2015031532	MO

General Provider Information

NPI Number	:	1295104214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTOPHER THOMA DC PC

Provider Business Mailing Address
First Line	:	1700 TIMBER RIDGE ESTATES DR
Second Line	:
City	:	WILDWOOD
State	:	MO
Zip	:	63011-1974
Country	:	US
Telephone Number	:	660-888-1708
Fax Number	:	636-391-0437

Provider Business Practice Location Address
First Line	:	300 OZARK TRAIL DR STE 105
Second Line	:
City	:	ELLISVILLE
State	:	MO
Zip	:	63011-2156
Country	:	US
Telephone Number	:	636-207-6600
Fax Number	:	636-207-6631

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	DR. CHRISTOPHER FRANKLIN THOMA
Credential	:	DC
Telephone Number	:	660-888-1708

Provider Enumeration Date	:	09/21/2015
Last Update Date	:	02/07/2023

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