Provider Demographics
NPI:1508397597
Name:ELIZABETH THORNE LLC
Entity Type:Organization
Organization Name:ELIZABETH THORNE LLC
Other - Org Name:BACK HOME CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-353-5659
Mailing Address - Street 1:6264 LEWIS DR
Mailing Address - Street 2:STE 101
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3603
Mailing Address - Country:US
Mailing Address - Phone:913-353-5659
Mailing Address - Fax:
Practice Address - Street 1:6264 LEWIS DR
Practice Address - Street 2:STE 101
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-3603
Practice Address - Country:US
Practice Address - Phone:913-353-5659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015015202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty