Healthcare Provider Details

I. General information

NPI: 1659505329
Provider Name (Legal Business Name): THORNTON CHIROPRACTIC CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 LITHIA PINECREST RD
BRANDON FL
33511-6121
US

IV. Provider business mailing address

906 LITHIA PINECREST RD
BRANDON FL
33511-6121
US

V. Phone/Fax

Practice location:
  • Phone: 813-685-7107
  • Fax: 813-681-9693
Mailing address:
  • Phone: 813-685-7107
  • Fax: 813-681-9693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. GLEN SCOTT THORNTON
Title or Position: PRESIDENT
Credential: DC
Phone: 813-685-7107