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Individual

MARK THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
3155 CHANNING WAY, SUITE D, IDAHO FALLS, ID 83404-7534
(208) 552-2700
(208) 552-1533
Mailing address
1560 S CAROL ST, MERIDIAN, ID 83646-1839
(208) 288-1155
(208) 288-0424

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3573
ID

Other

Enumeration date
06/04/2014
Last updated
06/04/2014
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