Individual
MARY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
(610) 834-7525
Mailing address
370 RED DOG RD, BUTLER, PA 16001-0774
(724) 283-1942
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN100725L
PA
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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