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General NPI Number Information
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NPI Number | 1487102695
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Entity Type | Individual
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Provider Name | LORI RENAE THOMPSON DPT
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Gender | Female
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 7331 E OSBORN DR STE 410
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6422
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Country | US
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Telephone | 480-443-0409
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 164
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City | DUCHESNE
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State | UT
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Zip | 84021-0164
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Country | US
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Telephone | 435-840-8116
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12125
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9636095-2401
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License Number State | UT
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