Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT 3483 | FL |
NPI | 1255356978 |
---|---|
Provider Name | Ms. Patricia Ann Thompson |
First Address | Clermont, FL 34713-6662 |
Second Address | Clermont, FL 34714-7508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |