Provider Demographics
NPI:1144600867
Name:CHRIS THOMPSON P.A.
Entity Type:Organization
Organization Name:CHRIS THOMPSON P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-996-7585
Mailing Address - Street 1:1200 S MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BELLE GLADE
Mailing Address - State:FL
Mailing Address - Zip Code:33430-7808
Mailing Address - Country:US
Mailing Address - Phone:561-996-7585
Mailing Address - Fax:561-992-8872
Practice Address - Street 1:1200 S MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-7808
Practice Address - Country:US
Practice Address - Phone:561-996-7585
Practice Address - Fax:561-992-8872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZCH 8823111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty