Individual
ASHLEY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14856 EDGEWATER RD NE, PINE CITY, MN 55063-5642
(320) 364-0164
Mailing address
260 MATTSON RD, MORA, MN 55051-7121
(320) 364-0164
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
395932
MN
Other
Enumeration date
04/21/2020
Last updated
04/21/2020
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