Provider Demographics
NPI:1215998950
Name:ROSS, THOMAS BRETT (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BRETT
Last Name:ROSS
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 1:1301 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3826
Mailing Address - Country:US
Mailing Address - Phone:609-581-1300
Mailing Address - Fax:609-581-9026
Practice Address - Street 1:1301 WHITEHORSE-MERCERVILLE ROAD
Practice Address - Street 2:
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-581-1300
Practice Address - Fax:609-581-9026
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ072872Medicare ID - Type Unspecified