Provider Demographics
NPI:1083942528
Name:THORNTON, NIKKI LATOYA (DC)
Entity Type:Individual
Prefix:DR
First Name:NIKKI
Middle Name:LATOYA
Last Name:THORNTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 DAWN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2864
Mailing Address - Country:US
Mailing Address - Phone:512-863-7000
Mailing Address - Fax:512-231-1087
Practice Address - Street 1:3007 DAWN DR STE 101
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2864
Practice Address - Country:US
Practice Address - Phone:512-863-7000
Practice Address - Fax:512-231-1087
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31459111N00000X
TX12015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor