Provider Demographics
NPI:1376712588
Name:THOMPSON, ANNIE R (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:R
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 1:110 S STANFIELD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-2331
Mailing Address - Country:US
Mailing Address - Phone:937-339-8509
Mailing Address - Fax:937-339-6499
Practice Address - Street 1:110 S STANFIELD RD
Practice Address - Street 2:SUITE B
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2331
Practice Address - Country:US
Practice Address - Phone:937-339-8509
Practice Address - Fax:937-339-6499
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor