Healthcare Provider Details

I. General information

NPI: 1982843298
Provider Name (Legal Business Name): KYLE ROBERT THOMPSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HUDSON RD STE A
CEDAR FALLS IA
50613-2304
US

IV. Provider business mailing address

1001 HUDSON RD STE A
CEDAR FALLS IA
50613-2304
US

V. Phone/Fax

Practice location:
  • Phone: 319-277-5616
  • Fax:
Mailing address:
  • Phone: 319-277-5616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number007143
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number007143
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: