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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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