Provider Demographics
NPI:1447450093
Name:THOMAS, LEE EASTON (DC)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:EASTON
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 1:3477 COMMERCE PKWY
Mailing Address - Street 2:SUITE B1
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7126
Mailing Address - Country:US
Mailing Address - Phone:330-601-1575
Mailing Address - Fax:330-601-1375
Practice Address - Street 1:3477 COMMERCE PKWY
Practice Address - Street 2:SUITE B1
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7126
Practice Address - Country:US
Practice Address - Phone:330-601-1575
Practice Address - Fax:330-601-1375
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1447450093Medicare PIN
OH1124321336Medicare UPIN
OH4277432Medicare PIN
OH9392221Medicare PIN