Provider Demographics
NPI:1366443178
Name:THRESS, JAMES HERMAN (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HERMAN
Last Name:THRESS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E PRICE ST
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-3028
Mailing Address - Country:US
Mailing Address - Phone:417-334-4441
Mailing Address - Fax:417-334-4441
Practice Address - Street 1:120 E PRICE ST
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-3028
Practice Address - Country:US
Practice Address - Phone:417-334-4441
Practice Address - Fax:417-334-4441
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOU86584Medicare UPIN
MO000031546Medicare ID - Type Unspecified