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General NPI Number Information
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NPI Number | 1932676624
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Entity Type | Individual
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Provider Name | JASON TUCKER THOMSEN DC
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Gender | Male
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 363 N UNIVERSITY AVE STE 105
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City | PROVO
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State | UT
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Zip | 84601-8422
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Country | US
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Telephone | 801-874-3455
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Fax |
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Provider Business Mailing Address
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Address Line | 363 N UNIVERSITY AVE STE 105
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City | PROVO
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State | UT
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Zip | 84601-8422
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Country | US
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Telephone | 801-874-3455
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Fax |
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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 | CH12596
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 13222504-1202
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License Number State | UT
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