Individual
LASHUN DENESE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1154 E HAWKINS PKWY, LONGVIEW, TX 75605-7975
(903) 663-2750
Mailing address
794 PEGUES RD, LONGVIEW, TX 75603-6616
(903) 399-3727
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2054539
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054539
HMO
—
Enumeration date
09/04/2018
Last updated
09/04/2018
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