Provider Demographics
NPI:1255330684
Name:THOMPSON, GAYLE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:MARIE
Last Name:THOMPSON
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 1:404 S LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:TABOR CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28463-2316
Mailing Address - Country:US
Mailing Address - Phone:910-653-3242
Mailing Address - Fax:910-653-2304
Practice Address - Street 1:404 S LEWIS ST
Practice Address - Street 2:
Practice Address - City:TABOR CITY
Practice Address - State:NC
Practice Address - Zip Code:28463-2316
Practice Address - Country:US
Practice Address - Phone:910-653-3242
Practice Address - Fax:910-653-2304
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor