Healthcare Provider Details

I. General information

NPI: 1124141080
Provider Name (Legal Business Name): PATRICIA ARLENE THOMPSON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S NEOSHO BLVD
NEOSHO MO
64850-1605
US

IV. Provider business mailing address

115 S NEOSHO BLVD
NEOSHO MO
64850-1605
US

V. Phone/Fax

Practice location:
  • Phone: 417-451-0900
  • Fax: 417-451-0900
Mailing address:
  • Phone: 417-451-0900
  • Fax: 417-451-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number004842
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: