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Individual

CORY MICHAEL THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
17538 12TH AVE NE APT B513, SHORELINE, WA 98155-3777
(518) 728-7516
Mailing address
17538 12TH AVE NE APT B513, SHORELINE, WA 98155-3777
(518) 728-7516

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
021112
NY
225700000X
Massage Therapist
MA60537199
WA

Other

Enumeration date
09/08/2015
Last updated
09/08/2015
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