Provider Demographics
NPI:1811133648
Name:TOMPKINS INSTITUTE OF CHIROPRACTIC
Entity type:Organization
Organization Name:TOMPKINS INSTITUTE OF CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-795-4732
Mailing Address - Street 1:1345 MARTIN CT APT 423
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2568
Mailing Address - Country:US
Mailing Address - Phone:386-795-4732
Mailing Address - Fax:
Practice Address - Street 1:2591 BAGLYOS CIR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8027
Practice Address - Country:US
Practice Address - Phone:386-795-4732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty