MEDICARE: DR. BRYAN THOMPSON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	9091013-1202	UT

General Provider Information

NPI Number	:	1053719328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN THOMPSON DC

Provider Business Mailing Address
First Line	:	63 NORTH MAIN STREET
Second Line	:
City	:	FARMINGTON
State	:	UT
Zip	:	84025-9626
Country	:	US
Telephone Number	:	801-721-1155
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 NORTH MAIN STREET
Second Line	:
City	:	FARMINGTON
State	:	UT
Zip	:	84025-8402
Country	:	US
Telephone Number	:	801-721-1155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2014
Last Update Date	:	01/02/2019

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Directions to “ DR. BRYAN THOMPSON DC” Practice Location

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