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NPI 1336739192

NPI 1336739192 : WILLIAM JAMES THOMPSON LMT : NORTH PLATTE, NE

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General NPI Number Information
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    NPI Number           |    1336739192
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM JAMES THOMPSON LMT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/25/2021
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    Last Update Date     |    01/27/2021
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Provider Practice Location Address
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    Address Line         |    1811 W A ST 
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    City                 |    NORTH PLATTE
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    State                |    NE
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    Zip                  |    69101-4534
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    Country              |    US
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    Telephone            |    308-534-3948
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    Fax                  |    308-221-2444
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Provider Business Mailing Address
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    Address Line         |    1811 W A ST 
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    City                 |    NORTH PLATTE
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    State                |    NE
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    Zip                  |    69101-4534
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    Country              |    US
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    Telephone            |    308-534-3948
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    Fax                  |    308-221-2444
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    2003
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    License Number State |    NE
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