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General NPI Number Information
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NPI Number | 1447983598
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Entity Type | Individual
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Provider Name | THOMPSON MAESAKA DC
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Gender | Male
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 10900 HAMPSHIRE AVE S STE 120
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City | BLOOMINGTON
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State | MN
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Zip | 55438-2699
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Country | US
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Telephone | 732-595-2333
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Fax |
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Provider Business Mailing Address
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Address Line | 5241 LINCOLN DR APT 314
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City | EDINA
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State | MN
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Zip | 55436-2703
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Country | US
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Telephone | 952-356-2295
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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 | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 6994
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License Number State | MN
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