Provider Demographics
NPI:1134211071
Name:THOMPSON, CARRIE MARIE ROSS (DC)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:MARIE ROSS
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:MARIE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:112 W 2ND ST
Mailing Address - Street 2:STE. A
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1908
Mailing Address - Country:US
Mailing Address - Phone:952-448-2722
Mailing Address - Fax:952-448-2768
Practice Address - Street 1:112 W 2ND ST
Practice Address - Street 2:STE A
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1908
Practice Address - Country:US
Practice Address - Phone:952-448-2722
Practice Address - Fax:952-448-2768
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2450111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor