Provider Demographics
NPI:1841386620
Name:THOMPSON, REID EVAN (DC)
Entity Type:Individual
Prefix:DR
First Name:REID
Middle Name:EVAN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:REID
Other - Middle Name:EVAN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:914 13TH AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405
Mailing Address - Country:US
Mailing Address - Phone:406-761-3767
Mailing Address - Fax:
Practice Address - Street 1:914 13TH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405
Practice Address - Country:US
Practice Address - Phone:406-761-3767
Practice Address - Fax:406-761-3038
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT474111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor