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General NPI Number Information
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NPI Number | 1225287964
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Entity Type | Organization
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Legal Business Name | THATCHER CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 3120 WINDSOR CT STE B
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City | ELKHART
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State | IN
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Zip | 46514-5556
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Country | US
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Telephone | 574-264-3344
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Fax | 574-264-1901
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Provider Business Mailing Address
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Address Line | 3120 WINDSOR CT STE B
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City | ELKHART
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State | IN
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Zip | 46514-5556
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Country | US
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Telephone | 574-264-3344
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Fax | 574-264-1901
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHNNETT THATCHER
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Credential | DC
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Telephone | 574-264-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 08001506A
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License Number State | IN
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