Individual
MISS LYNETTE FAYE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
405 STANAFORD RD, BECKLEY, WV 25801-3143
(304) 252-6317
Mailing address
209 ANGELS RST, BECKLEY, WV 25801-3403
(304) 673-1896
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001344
WV
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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