MEDICARE: THOMAS CHIROPRACTIC CLINIC INC

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	CH0004323	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	350056451	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	361657900	OTHER	FL	OWCP
2	70320	OTHER	FL	BLUE CROSS BLUE SHIELD
3	3822596	OTHER	FL	HEALTHSMART

General Provider Information

NPI Number	:	1922032762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS CHIROPRACTIC CLINIC INC

Provider Business Mailing Address
First Line	:	1508 SW MAPP RD
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-2446
Country	:	US
Telephone Number	:	772-781-9987
Fax Number	:	772-781-5384

Provider Business Practice Location Address
First Line	:	1508 SW MAPP RD
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-2446
Country	:	US
Telephone Number	:	772-781-9987
Fax Number	:	772-781-5384

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS D KLEINMAN
Credential	:	DC
Telephone Number	:	772-781-9987

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	05/20/2010

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