Provider Demographics
NPI:1174898688
Name:THOMPSON FAMILY CHIROPRACTIC INC
Entity type:Organization
Organization Name:THOMPSON FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:P
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:785-543-2202
Mailing Address - Street 1:675 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-2138
Mailing Address - Country:US
Mailing Address - Phone:785-543-2202
Mailing Address - Fax:
Practice Address - Street 1:675 3RD ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661-2138
Practice Address - Country:US
Practice Address - Phone:785-543-2202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSC-3929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060454OtherMEDICARE ID - UNSPCIFIED
KST93599Medicare UPIN