Individual
MICHAEL A THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
13825 W BURLEIGH RD, BROOKFIELD, WI 53005-3058
(262) 754-3446
(262) 754-3451
Mailing address
W351N6018 BAUERS LN, OCONOMOWOC, WI 53066-1818
(262) 754-3446
(262) 754-3451
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
271-039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891711008
OFFICE NPI
WI
Enumeration date
04/24/2007
Last updated
07/08/2007
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