Provider Demographics
NPI:1780800854
Name:GRAZIANO, THOMAS WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:GRAZIANO
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 1:580 REED RD
Mailing Address - Street 2:SUITE 8A
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3655
Mailing Address - Country:US
Mailing Address - Phone:610-356-2300
Mailing Address - Fax:610-356-6042
Practice Address - Street 1:580 REED RD
Practice Address - Street 2:SUITE 8A
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3655
Practice Address - Country:US
Practice Address - Phone:610-356-2300
Practice Address - Fax:610-356-6042
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 05416-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor