Provider Demographics
NPI:1255599361
Name:THORNTON, PERRY JR (DC)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:
Last Name:THORNTON
Suffix:JR
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 1:6401 EDGEWATER CV
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-4624
Mailing Address - Country:US
Mailing Address - Phone:404-234-9152
Mailing Address - Fax:
Practice Address - Street 1:6401 EDGEWATER CV
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-4624
Practice Address - Country:US
Practice Address - Phone:404-234-9152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006643111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor