Provider Demographics
NPI:1083828388
Name:THORNTON NATURAL HEALTHCARE CENTRE
Entity Type:Organization
Organization Name:THORNTON NATURAL HEALTHCARE CENTRE
Other - Org Name:THORNTON FAMILY CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:DWAIN
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCI
Authorized Official - Phone:417-276-6306
Mailing Address - Street 1:205 SOUTH ST.
Mailing Address - Street 2:PO BOX 1028
Mailing Address - City:STOCKTON
Mailing Address - State:MO
Mailing Address - Zip Code:65785-1028
Mailing Address - Country:US
Mailing Address - Phone:417-276-6306
Mailing Address - Fax:417-276-6216
Practice Address - Street 1:205 SOUTH ST.
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:MO
Practice Address - Zip Code:65785-1028
Practice Address - Country:US
Practice Address - Phone:417-276-6306
Practice Address - Fax:417-276-6216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004017332111N00000X
MO6617111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty