Individual
CASEY BROOKE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
38 SACANDAGA RD, SCOTIA, NY 12302-1214
(518) 428-7889
Mailing address
45 BROADWAY APT 1, RENSSELAER, NY 12144-2915
(518) 428-7889
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1208664181
NY
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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