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Individual

JESSICA THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
750 S ORANGE BLOSSOM TRL STE 104, ORLANDO, FL 32805-3154
(407) 371-1860
Mailing address
547 TAFT DR, DAVENPORT, FL 33837-3694
(407) 371-1860

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
COU-1085200
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
85-4207888
FL
Enumeration date
04/05/2022
Last updated
04/05/2022
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