Individual
COLLIN THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1221 N DUTTON AVE, SANTA ROSA, CA 95401-4607
(707) 543-8360
Mailing address
127 VINEYARD CIR, SONOMA, CA 95476-8041
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
297838
CA
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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