Provider Demographics
NPI:1477501492
Name:THORP, JOHN ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALAN
Last Name:THORP
Suffix:
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:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:SARANAC
Mailing Address - State:MI
Mailing Address - Zip Code:48881-0174
Mailing Address - Country:US
Mailing Address - Phone:616-642-9455
Mailing Address - Fax:616-642-9456
Practice Address - Street 1:11 MAIN ST
Practice Address - Street 2:
Practice Address - City:SARANAC
Practice Address - State:MI
Practice Address - Zip Code:48881-0174
Practice Address - Country:US
Practice Address - Phone:616-642-9455
Practice Address - Fax:616-642-9456
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI97OC450070OtherBCBSM
MI0M71920Medicare PIN