Provider Demographics
NPI:1114184009
Name:THOMPSON CHIROPRACTIC AND WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:THOMPSON CHIROPRACTIC AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:443-745-8905
Mailing Address - Street 1:5513 TWIN KNOLLS RD STE 219
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3264
Mailing Address - Country:US
Mailing Address - Phone:443-745-8905
Mailing Address - Fax:410-474-0111
Practice Address - Street 1:5513 TWIN KNOLLS RD STE 219
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3264
Practice Address - Country:US
Practice Address - Phone:410-740-1112
Practice Address - Fax:410-474-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO3413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty