Provider Demographics
NPI:1346314325
Name:DAVID A. THORPE
Entity Type:Organization
Organization Name:DAVID A. THORPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-637-0706
Mailing Address - Street 1:7211 EAST GENESEE STREET
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13066
Mailing Address - Country:US
Mailing Address - Phone:315-637-0706
Mailing Address - Fax:315-637-0708
Practice Address - Street 1:7211 EAST GENESEE STREET
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13066
Practice Address - Country:US
Practice Address - Phone:315-637-0706
Practice Address - Fax:315-637-0708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD4984Medicare ID - Type UnspecifiedMEDICARE ID