MEDICARE: ROBERT B 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	0104000576	VA

General Provider Information

NPI Number	:	1831547371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT B THOMA DC PC

Provider Business Mailing Address
First Line	:	2244 SUNSTATES CT
Second Line	:	#104
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1552
Country	:	US
Telephone Number	:	757-481-5444
Fax Number	:

Provider Business Practice Location Address
First Line	:	2244 SUNSTATES CT
Second Line	:	#104
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1552
Country	:	US
Telephone Number	:	757-481-5444
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	ROBERT B. THOMA
Credential	:	D.C.
Telephone Number	:	757-481-5444

Provider Enumeration Date	:	05/25/2016
Last Update Date	:	08/10/2016

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