Basic Information
| Provider Information | |||||||||
| NPI: | 1285965699 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THOMPSON CHIROPRACTIC CENTER PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 ROUTE 9 | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LANOKA HARBOR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087342818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099713500 | ||||||||
| FaxNumber: | 6099713545 | ||||||||
| Practice Location | |||||||||
| Address1: | 411 ROUTE 9 | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LANOKA HARBOR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087342818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099713500 | ||||||||
| FaxNumber: | 6099713545 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2010 | ||||||||
| LastUpdateDate: | 01/25/2010 | ||||||||
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| AuthorizedOfficialLastName: | THOMPSON | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | DAVID | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6099713500 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | D.C., C.C.S.P. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111NS0005X | 38MC00626200 | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor | Sports Physician |
ID Information
| ID | Type | State | Issuer | Description | 2348312000 | 01 | NJ | AMERIHEALTH | OTHER | P3395950 | 01 | NJ | OXFORD HEALTH PLANS | OTHER | 3646590 | 01 | NJ | AETNA | OTHER |