MEDICARE: THOMAS J ORTH 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	5176	IA
2	111N00000X	Chiropractor	700	SD

General Provider Information

NPI Number	:	1609950203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS J ORTH DC PC

Provider Business Mailing Address
First Line	:	208 ISLAND DR STE 10
Second Line	:
City	:	FORT PIERRE
State	:	SD
Zip	:	57532-7301
Country	:	US
Telephone Number	:	605-222-0510
Fax Number	:

Provider Business Practice Location Address
First Line	:	208 ISLAND DR STE 10
Second Line	:
City	:	FORT PIERRE
State	:	SD
Zip	:	57532-7301
Country	:	US
Telephone Number	:	605-222-0510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	11/19/2021

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Directions to “ THOMAS J ORTH DC PC” Practice Location

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