Individual
JOHN WESLEY THOMPSON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1450 CLAIBORNE AVE, SHREVEPORT, LA 71103-4204
(318) 813-2962
(318) 813-2981
Mailing address
1219 CHURCH ST, ZACHARY, LA 70791-2347
(225) 658-7751
(225) 658-7753
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08075
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174173
—
LA
Enumeration date
07/13/2011
Last updated
09/26/2012
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