Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1584 | NE |
NPI | 1003048471 |
---|---|
Provider Name | Dr. Kimberly K Thor |
First Address | Norfolk, NE 68701-5233 |
Second Address | Norfolk, NE 68701-5233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2009 |
Last Update Date | 07/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
099691002 | (02) | NE |
10025744100 | (05) | NE |