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Individual
SALLY ELIZABETH THOMPSON
Active
Individual
SALLY ELIZABETH THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 9103789
FL
363A00000X
Physician Assistant
Primary
PA9103789
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000848900
—
FL
Enumeration date
10/17/2006
Last updated
12/08/2010
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