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Individual

MR. JOHN STEPHEN THACKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC, CMTPT

Contact information

Practice address
508 S MAIN ST, SUITE B, BLACKSBURG, VA 24060-4863
(540) 315-9763
(540) 605-7311
Mailing address
508 S MAIN ST, SUITE B, BLACKSBURG, VA 24060-4863
(540) 315-9763
(540) 605-7311

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
0121000432
VA

Other

Enumeration date
02/13/2017
Last updated
02/13/2017
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