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NPI Code Detail

MEDICARE: DR. THOMAS G JICHA D.C.

MEDICARE: DR. THOMAS G JICHA D.C.
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
1111N00000XChiropractor1084OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700940376
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS G JICHA D.C.
Provider Business Mailing Address
First Line : 1233 W MARKET ST
Second Line :
City : LIMA
State : OH
Zip : 45805-2728
Country : US
Telephone Number : 419-227-8435
Fax Number : 419-227-1772
Provider Business Practice Location Address
First Line : 1233 W MARKET ST
Second Line :
City : LIMA
State : OH
Zip : 45805-2728
Country : US
Telephone Number : 419-227-8435
Fax Number : 419-227-1772
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 10/17/2007

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