Dr Tyron R Thompson, DC | |
1550 Lemoine Ave Ste 101, Fort Lee, NJ 07024-5608 | |
(551) 313-9689 | |
Not Available |
Full Name | Dr Tyron R Thompson |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 1550 Lemoine Ave Ste 101, Fort Lee, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750017067 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 38MC00792400 (New Jersey) | Primary |
Provider Name | Sportsmed Pt Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1841787645 PECOS PAC ID: 0749535805 Enrollment ID: O20180614001056 |
Mailing Address | Practice Location Address |
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Dr Tyron R Thompson, DC 28-07 Zachary Ter, Fair Lawn, NJ 07410-3927 Ph: (201) 220-1125 | Dr Tyron R Thompson, DC 1550 Lemoine Ave Ste 101, Fort Lee, NJ 07024-5608 Ph: (551) 313-9689 |
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