Provider Demographics
NPI:1770651648
Name:THORNTON, DAMON DRU (DC)
Entity Type:Individual
Prefix:DR
First Name:DAMON
Middle Name:DRU
Last Name:THORNTON
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 678705
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32867-8705
Mailing Address - Country:US
Mailing Address - Phone:407-478-4848
Mailing Address - Fax:407-386-6770
Practice Address - Street 1:1320 S ORLANDO AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5556
Practice Address - Country:US
Practice Address - Phone:407-478-4848
Practice Address - Fax:407-386-6770
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor