Provider Demographics
NPI:1487640843
Name:THOMPSON, JOHN F (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:509 W MAIN ST
Mailing Address - Street 2:SUITE A#63
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:UT
Mailing Address - Zip Code:84647-1375
Mailing Address - Country:US
Mailing Address - Phone:435-462-3221
Mailing Address - Fax:435-462-3221
Practice Address - Street 1:509 W MAIN ST
Practice Address - Street 2:SUITE A#63
Practice Address - City:MOUNT PLEASANT
Practice Address - State:UT
Practice Address - Zip Code:84647-1375
Practice Address - Country:US
Practice Address - Phone:435-462-3221
Practice Address - Fax:435-462-3221
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT163458-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTT83801Medicare UPIN