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Individual

DAVID LEE THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
20 LAUREL DR, SHADY COVE, OR 97539-3602
(541) 613-2099
Mailing address
20 LAUREL DR, SHADY COVE, OR 97539-3602
(541) 613-2099

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
8695
OR
225200000X
Physical Therapy Assistant
Primary
PTA2211
MT

Other

Enumeration date
03/16/2009
Last updated
07/31/2015
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