1659505329 NPI number — THORNTON CHIROPRACTIC CENTER, P.A.

Table of content: (NPI 1659505329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659505329 NPI number — THORNTON CHIROPRACTIC CENTER, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THORNTON CHIROPRACTIC CENTER, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659505329
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
906 LITHIA PINECREST RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRANDON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33511-6121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-685-7107
Provider Business Mailing Address Fax Number:
813-681-9693

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
906 LITHIA PINECREST RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRANDON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33511-6121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-685-7107
Provider Business Practice Location Address Fax Number:
813-681-9693
Provider Enumeration Date:
05/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
THORNTON
Authorized Official First Name:
GLEN
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
813-685-7107

Provider Taxonomy Codes

  • Taxonomy code: 111NN1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 22309 . This is a "MEDICARE PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 350035028 . This is a "RAILROAD MEDICARE PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com