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General NPI Number Information
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NPI Number | 1518026152
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Entity Type | Organization
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Legal Business Name | THRASH CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 1601A N 16TH ST
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City | ORANGE
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State | TX
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Zip | 77630-3615
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Country | US
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Telephone | 409-886-7246
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Fax | 409-886-1219
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Provider Business Mailing Address
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Address Line | 11025 ARBOR WOOD
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City | BEAUMONT
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State | TX
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Zip | 77705
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Country | US
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Telephone | 409-886-7246
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Fax | 409-886-1219
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Authorized Official
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Title or Position | DOCTOR OWNER
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Name | DR. DAVID THRASH
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Credential | D.C.
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Telephone | 409-886-7246
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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 | 1249
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License Number State | AR
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