Provider Demographics
NPI:1649456427
Name:THOMPSON CHIROPRACTIC SERVICES, P.C.
Entity type:Organization
Organization Name:THOMPSON CHIROPRACTIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:CH
Authorized Official - Phone:607-754-3336
Mailing Address - Street 1:701 CIERI DR
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-2219
Mailing Address - Country:US
Mailing Address - Phone:607-754-3336
Mailing Address - Fax:
Practice Address - Street 1:701 CIERI DR
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-2219
Practice Address - Country:US
Practice Address - Phone:607-754-3336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009102-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY504872510002OtherCIGNA
NY605859OtherEMPIRE
NYNY09102OtherMVP
NY0005299664OtherAETNA
NY0005299664OtherAETNA
NY=========002OtherRMSCO