Individual
MR. DEREK CHASE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
200 MULBERY STREET SUITE C, BOONEVILLE, KY 41313
(606) 593-6003
Mailing address
510 REGIONAL AIRPORT RD, CHAVIES, KY 41727-8646
(606) 435-8284
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02681
KY
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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