Provider Demographics
NPI:1194193466
Name:THOMAS, BRANDON M (DC)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10132 CARD RD
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-5116
Mailing Address - Country:US
Mailing Address - Phone:423-401-0922
Mailing Address - Fax:
Practice Address - Street 1:10132 CARD RD
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-5116
Practice Address - Country:US
Practice Address - Phone:423-401-0922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33377111N00000X
TN3761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor