Provider Demographics
NPI:1336366129
Name:THOMPSON, DEBRA L (DC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:THOMPSON
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 1:1672 S TAFT AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-7275
Mailing Address - Country:US
Mailing Address - Phone:970-744-7954
Mailing Address - Fax:
Practice Address - Street 1:1530 BOISE AVE STE 205A
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4240
Practice Address - Country:US
Practice Address - Phone:970-744-7954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor