Provider Demographics
NPI:1427130244
Name:ROTTET, THOMAS A (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:ROTTET
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 1:1120 CENTRE TPKE
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-9191
Mailing Address - Country:US
Mailing Address - Phone:570-366-2613
Mailing Address - Fax:570-366-2618
Practice Address - Street 1:1120 CENTRE TPKE
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-9191
Practice Address - Country:US
Practice Address - Phone:570-366-2613
Practice Address - Fax:570-366-2618
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006103L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA643047Medicare PIN
PAU55567Medicare UPIN