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General NPI Number Information
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NPI Number | 1902019789
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Entity Type | Individual
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Provider Name | JEAN ELLEN THOMPSON D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 5513 TWIN KNOLLS RD STE 219
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City | COLUMBIA
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State | MD
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Zip | 21045-3264
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Country | US
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Telephone | 410-740-1112
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Fax | 104-740-1117
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Provider Business Mailing Address
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Address Line | 5513 TWIN KNOLLS RD STE 219
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City | COLUMBIA
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State | MD
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Zip | 21045-3264
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Country | US
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Telephone | 443-745-8905
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Fax | 104-740-1117
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3413
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License Number State | MD
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