Individual
TAYLOR THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 S MARIO CAPECCHI DR, SALT LAKE CITY, UT 84112-5888
(208) 407-9992
Mailing address
15359 RIVERSIDE RD, CALDWELL, ID 83607-9627
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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