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General NPI Number Information
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NPI Number | 1063390185
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Entity Type | Individual
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Provider Name | CATHERINE ANN THOMPSON PTA
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Gender | Female
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 2904 ROOSEVELT RD STE 1
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City | SAINT CLOUD
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State | MN
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Zip | 56301-9109
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Country | US
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Telephone | 320-558-8315
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Fax | 320-558-8380
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Provider Business Mailing Address
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Address Line | 2904 ROOSEVELT RD STE 1
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City | SAINT CLOUD
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State | MN
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Zip | 56301-9109
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Country | US
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Telephone | 320-558-8315
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Fax | 320-558-8380
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A643
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License Number State | MN
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