Individual
MR. DAVID SHANNON THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
3501 ALTAMA AVE, BRUNSWICK, GA 31520-3629
(912) 261-8117
(912) 261-8301
Mailing address
3501 ALTAMA AVE, BRUNSWICK, GA 31520-3629
(912) 261-8117
(912) 261-8301
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
01521
GA
224P00000X
Prosthetist
Primary
01521
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00742871A
—
GA
Enumeration date
07/07/2005
Last updated
11/07/2007
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