Provider Demographics
NPI:1295825131
Name:THOMPSON, LAWRENCE E (DC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:E
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:LARRY
Other - Middle Name:E
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:400 WEST FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460
Mailing Address - Country:US
Mailing Address - Phone:620-241-5272
Mailing Address - Fax:620-241-4562
Practice Address - Street 1:400 WEST FIRST STREET
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460
Practice Address - Country:US
Practice Address - Phone:620-241-5272
Practice Address - Fax:620-241-4562
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSC3105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T77088Medicare ID - Type Unspecified