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General NPI Number Information
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NPI Number | 1982788618
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Entity Type | Organization
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Legal Business Name | THOMPSON FAMILY CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 257 AIRPORT RD STE B
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City | OZARK
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State | AR
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Zip | 72949-9266
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Country | US
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Telephone | 479-667-9760
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Fax | 479-667-1606
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Provider Business Mailing Address
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Address Line | 257 AIRPORT RD STE B
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City | OZARK
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State | AR
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Zip | 72949-9266
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Country | US
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Telephone | 479-667-9760
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Fax | 479-667-1606
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANDALL JAY THOMPSON
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Credential | DC
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Telephone | 479-667-9760
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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 | AR 1531
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License Number State | AR
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