Provider Demographics
NPI:1346356896
Name:THUERCK, JOHN W III (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:THUERCK
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14801 W COUNTRY GABLES DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-5416
Mailing Address - Country:US
Mailing Address - Phone:623-882-9619
Mailing Address - Fax:
Practice Address - Street 1:2960 N LITCHFIELD RD STE 110
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7822
Practice Address - Country:US
Practice Address - Phone:623-882-9602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008216111N00000X
AZ5917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA7134Medicare ID - Type Unspecified
V05523Medicare UPIN