Healthcare Provider Details

I. General information

NPI: 1932794500
Provider Name (Legal Business Name): THOMPSON MEDICAL AND CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 03/05/2021
Certification Date: 03/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 W BAY AVE STE E
BARNEGAT NJ
08005-2150
US

IV. Provider business mailing address

424 S MAIN ST
FORKED RIVER NJ
08731-4654
US

V. Phone/Fax

Practice location:
  • Phone: 609-971-3500
  • Fax: 609-971-3545
Mailing address:
  • Phone: 609-971-3500
  • Fax: 609-971-3545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT DAVID THOMPSON
Title or Position: PRESIDENT
Credential:
Phone: 609-971-3500