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General NPI Number Information
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NPI Number | 1386123727
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Entity Type | Organization
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Legal Business Name | JAMES R. THWAITS LLC
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 09/25/2018
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Provider Practice Location Address
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Address Line | 502 N HUNTINGTON ST
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City | SYRACUSE
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State | IN
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Zip | 46567-1224
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Country | US
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Telephone | 574-457-7177
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Fax | 574-457-7177
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Provider Business Mailing Address
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Address Line | 502 N HUNTINGTON ST
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City | SYRACUSE
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State | IN
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Zip | 46567-1224
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Country | US
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Telephone | 574-457-7177
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Fax | 574-457-7177
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES R THWAITS
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Credential | DC
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Telephone | 745-457-7177
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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 | 753
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License Number State | IN
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