Individual
MRS. MADELEINE A THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, RD, LD
Contact information
Practice address
621 S NEW BALLAS RD STE 7008B, SAINT LOUIS, MO 63141-8275
(314) 251-8750
Mailing address
621 S NEW BALLAS RD STE 7008B, SAINT LOUIS, MO 63141-8275
(314) 251-8750
(314) 251-5571
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2108009745
MO
Other
Enumeration date
04/30/2018
Last updated
09/20/2022
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