Individual
BRYAN ANTHONY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPT
Contact information
Practice address
8819 W ECHO LN, PEORIA, AZ 85345-7834
(623) 877-9305
Mailing address
8819 W ECHO LN, PEORIA, AZ 85345-7834
(623) 877-9305
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
71212
AZ
Other
Enumeration date
12/26/2016
Last updated
12/26/2016
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