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Individual
MR. MATTHEW KARL THOMPSON
Active
Individual
MR. MATTHEW KARL THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT10471
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
888624500
—
FL
01
—
Y6308
BLUE CROSS/BLUE SHIELD PR
FL
Enumeration date
11/17/2005
Last updated
10/02/2015
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