Provider Demographics
NPI:1437336013
Name:THOMPSON CHIROPRACTIC
Entity Type:Organization
Organization Name:THOMPSON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:MYRON
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-368-3329
Mailing Address - Street 1:813B SHAKESPHEARE AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:IA
Mailing Address - Zip Code:50249
Mailing Address - Country:US
Mailing Address - Phone:515-297-1828
Mailing Address - Fax:
Practice Address - Street 1:1348 MEADOW LN
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-8731
Practice Address - Country:US
Practice Address - Phone:515-297-1828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-26
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06631261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care