Individual
TERRY M THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O.
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
49
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49
COMPOSITE STATE BOARD OF MEDICAL EXAMINERS OF GA
GA
01
—
CO 003087
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS & PROSTHETICS
—
Enumeration date
08/13/2010
Last updated
08/13/2010
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