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General NPI Number Information
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NPI Number | 1285965699
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Entity Type | Organization
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Legal Business Name | THOMPSON CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 01/25/2010
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 411 ROUTE 9 SUITE 1
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City | LANOKA HARBOR
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State | NJ
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Zip | 08734-2818
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Country | US
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Telephone | 609-971-3500
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Fax | 609-971-3545
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Provider Business Mailing Address
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Address Line | 411 ROUTE 9 SUITE 1
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City | LANOKA HARBOR
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State | NJ
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Zip | 08734-2818
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Country | US
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Telephone | 609-971-3500
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Fax | 609-971-3545
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT DAVID THOMPSON
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Credential | D.C., C.C.S.P.
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Telephone | 609-971-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 38MC00626200
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License Number State | NJ
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