Individual
MS. JENNIFER L THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT/CHT
Contact information
Practice address
1812 MARSH RD, STORE 505, WILMINGTON, DE 19810-4581
(302) 475-7500
(302) 894-1601
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
22232
MD
225100000X
Physical Therapist
Primary
J10001399
DE
225100000X
Physical Therapist
PT012717L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000037755
—
DE
01
—
2116451
MAMSI PROVIDER NUMBER
DE
01
—
2323901000
AMERIHEALTH
DE
01
—
P01038120
MEDICARE RAILROAD
DE
Enumeration date
06/22/2006
Last updated
06/27/2012
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