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Individual

DR. TERRY THOMAS THATCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1710 CROGHAN ST, FREMONT, OH 43420-2759
(419) 332-6351
(419) 332-6351
Mailing address
1710 CROGHAN ST, FREMONT, OH 43420-2759
(419) 332-6351
(419) 332-6351

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
496
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000127369
ANTHEM BLUE CROSS
OH
01
341105462
TAXPAYER ID NUMBER
OH
01
341105462-003
MEDICAL MUTUAL OF OHIO
OH
01
ANTHEM BLUE CROSS
ANTHEM BLUE CROSS
OH
Enumeration date
03/06/2007
Last updated
07/08/2007
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