Provider Demographics
NPI:1124305214
Name:BIRCHMEIER, THOMAS BRIAN (ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BRIAN
Last Name:BIRCHMEIER
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 E FRANCES RD
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-9778
Mailing Address - Country:US
Mailing Address - Phone:810-938-9622
Mailing Address - Fax:
Practice Address - Street 1:2805 E 10TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-2619
Practice Address - Country:US
Practice Address - Phone:812-856-4905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001714A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer