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General NPI Number Information
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NPI Number | 1366968174
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Entity Type | Organization
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Legal Business Name | THOMPSON PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4620 NW 39TH AVE STE B
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City | GAINESVILLE
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State | FL
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Zip | 32606-5952
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Country | US
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Telephone | 352-281-9660
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Fax | 888-726-9247
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Provider Business Mailing Address
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Address Line | 4620 NW 39TH AVE STE B
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City | GAINESVILLE
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State | FL
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Zip | 32606-5952
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Country | US
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Telephone | 352-281-9660
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Fax | 888-726-9247
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | DR. JUSTIN THOMPSON
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Credential | PT
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Telephone | 352-281-9660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT29245
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License Number State | FL
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