Provider Demographics
NPI:1285965699
Name:THOMPSON CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:THOMPSON CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:609-971-3500
Mailing Address - Street 1:411 ROUTE 9
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LANOKA HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08734-2818
Mailing Address - Country:US
Mailing Address - Phone:609-971-3500
Mailing Address - Fax:609-971-3545
Practice Address - Street 1:411 ROUTE 9
Practice Address - Street 2:SUITE 1
Practice Address - City:LANOKA HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08734-2818
Practice Address - Country:US
Practice Address - Phone:609-971-3500
Practice Address - Fax:609-971-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00626200111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2348312000OtherAMERIHEALTH
NJP3395950OtherOXFORD HEALTH PLANS
NJ3646590OtherAETNA
NJ084805Medicare PIN