Individual
MRS. TARA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4320 E. PRESIDIO STREET, #101, MESA, AZ 85215-1165
(480) 706-9430
(480) 378-2273
Mailing address
5155 E. EAGLE DRIVE, #20730, MESA, AZ 85277-3031
(520) 407-6750
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6897
AZ
Other
Enumeration date
08/21/2017
Last updated
04/19/2018
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