Provider Demographics
NPI:1902029788
Name:THOMPSON, HOWARD COLEMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:COLEMAN
Last Name:THOMPSON
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 1:46641 N BLACK CANYON HWY STE 10
Mailing Address - Street 2:
Mailing Address - City:NEW RIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85087-6941
Mailing Address - Country:US
Mailing Address - Phone:623-465-1012
Mailing Address - Fax:
Practice Address - Street 1:46641 N BLACK CANYON HWY STE 10
Practice Address - Street 2:
Practice Address - City:NEW RIVER
Practice Address - State:AZ
Practice Address - Zip Code:85087-6941
Practice Address - Country:US
Practice Address - Phone:623-465-1012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor