Healthcare Provider Details

I. General information

NPI: 1023100807
Provider Name (Legal Business Name): JANE ELLEN THOMPSON M.ED., M.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 FREMONT ST
OXFORD MA
01540-1919
US

IV. Provider business mailing address

2 FREMONT ST
OXFORD MA
01540-1919
US

V. Phone/Fax

Practice location:
  • Phone: 508-987-1978
  • Fax: 508-987-1978
Mailing address:
  • Phone: 508-987-1978
  • Fax: 508-987-1978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number687
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: