Individual
MS. BREANNE MARY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 288-8000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15200-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100147265
—
WI
Enumeration date
10/15/2020
Last updated
11/10/2023
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