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Organization
THOMAS M. LAFOUNTAIN CHIROPRACTIC
Active
Organization
THOMAS M. LAFOUNTAIN CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MICHAEL LAFOUNTAIN D.C. (CHIROPRACTOR)
(315) 732-3400
Entity
Organization
Contact information
Practice address
130 LOMOND CT, UTICA, NY 13502-5951
(315) 732-3400
(315) 732-4250
Mailing address
130 LOMOND CT, UTICA, NY 13502-5951
(315) 732-3400
(315) 732-4250
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
X003195
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0142707
GHI PROVIDER NUMBER
—
01
—
10032541
CDPHP PROVIDER NUMBER
—
01
—
1992724207
NPI INDIVIDUAL IDENTIFIER
—
01
—
P010003195
BCBS PROVIDER NUMBER
—
Enumeration date
02/28/2007
Last updated
01/13/2020
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