Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 583 | WY |
NPI | 1407937014 |
---|---|
Provider Name | Michael K Thompson |
First Address | Cheyenne, WY 82001-5917 |
Second Address | Cheyenne, WY 82001-5917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |