Provider Demographics
NPI:1194985432
Name:W. THOMAS TUREK, D.C.
Entity type:Organization
Organization Name:W. THOMAS TUREK, D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGAER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON-TUREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-748-3166
Mailing Address - Street 1:222 SUMMER ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-2364
Mailing Address - Country:US
Mailing Address - Phone:802-748-3166
Mailing Address - Fax:
Practice Address - Street 1:222 SUMMER ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-2364
Practice Address - Country:US
Practice Address - Phone:802-748-3166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0000678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0008781Medicaid
VT0008781Medicaid