Organization
BRADLEY S THOMPSON FAMILY LIMITED PARTNERSHIP NO ONE
Active
Other names
Bradley S Thompson Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY S THOMPSON DC (DOCTOR OWNER)
(662) 349-4494
Entity
Organization
Contact information
Practice address
7464 TCHULAHOMA ROAD, SOUTHAVEN, MS 38671
(662) 349-4494
(662) 349-4495
Mailing address
PO BOX 225, SOUTHAVEN, MS 38671
(662) 349-4494
(662) 349-4495
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3045182
BCBS
TN
01
—
350044428
RR MEDICARE
MS
Enumeration date
03/27/2007
Last updated
06/24/2014
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