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General NPI Number Information
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NPI Number | 1164677407
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Entity Type | Individual
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Provider Name | KIMBERLY J THOMPSON L.AC. MSTOM
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Gender | Female
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 6135 N BOOTH AVE
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City | MERIDIAN
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State | ID
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Zip | 83646-7364
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Country | US
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Telephone | 208-373-7733
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Fax |
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Provider Business Mailing Address
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Address Line | 6135 N BOOTH AVE
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City | MERIDIAN
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State | ID
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Zip | 83646-7364
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Country | US
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Telephone | 208-965-3777
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACU-244
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number |
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License Number State | ID
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