Healthcare Provider Details

I. General information

NPI: 1982965489
Provider Name (Legal Business Name): THOMPSON PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 06/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6222 N 1ST ST STE 104
FRESNO CA
93710-5448
US

IV. Provider business mailing address

6222 N 1ST ST STE 104
FRESNO CA
93710-5448
US

V. Phone/Fax

Practice location:
  • Phone: 559-365-5001
  • Fax: 559-354-5915
Mailing address:
  • Phone: 559-365-5001
  • Fax: 559-354-5915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT34420
License Number StateCA

VIII. Authorized Official

Name: MR. RYAN P THOMPSON
Title or Position: CEO
Credential: M.P.T.
Phone: 559-972-2863