MEDICARE: THOMPSON MEDICAL AND CHIROPRACTIC LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	111N00000X	Chiropractor
2	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician
3	213E00000X	Podiatrist
4	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1982194825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMPSON MEDICAL AND CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	424 S MAIN ST
Second Line	:
City	:	FORKED RIVER
State	:	NJ
Zip	:	08731-4654
Country	:	US
Telephone Number	:	609-971-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 APPLE ST STE 100C
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-2669
Country	:	US
Telephone Number	:	732-747-5022
Fax Number	:

Authorized Official
Title or Position	:	MANAGING EMPLOYEE
Name	:	ROBERT DAVID THOMPSON
Credential	:
Telephone Number	:	609-971-3500

Provider Enumeration Date	:	05/16/2018
Last Update Date	:	08/25/2021

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