Provider Demographics
NPI:1548295959
Name:THURSTON, DAVID JAMES (DC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAMES
Last Name:THURSTON
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 1:135 BERTRAND STREET
Mailing Address - Street 2:
Mailing Address - City:ST IGNACE
Mailing Address - State:MI
Mailing Address - Zip Code:49781
Mailing Address - Country:US
Mailing Address - Phone:906-643-9940
Mailing Address - Fax:906-643-9943
Practice Address - Street 1:135 BERTRAND STREET
Practice Address - Street 2:
Practice Address - City:ST IGNACE
Practice Address - State:MI
Practice Address - Zip Code:49781
Practice Address - Country:US
Practice Address - Phone:906-643-9940
Practice Address - Fax:906-643-9943
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDT006792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI144345061Medicaid
MI950D950020OtherBCBS
MI144345061Medicaid
MI950D950020OtherBCBS