Provider Demographics
NPI:1821758236
Name:THOMSON, CARLEE D (DC)
Entity Type:Individual
Prefix:DR
First Name:CARLEE
Middle Name:D
Last Name:THOMSON
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 1:1999 N THORNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-3560
Mailing Address - Country:US
Mailing Address - Phone:801-510-9368
Mailing Address - Fax:
Practice Address - Street 1:405 S 8TH ST STE 295
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-7100
Practice Address - Country:US
Practice Address - Phone:208-342-7136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-2221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor