Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PTH553 | AL |
NPI | 1184759086 |
---|---|
Provider Name | Richard Allen Thompson |
First Address | Madison, AL 35758-8671 |
Second Address | Huntsville, AL 35806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 08/07/2007 |