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General NPI Number Information
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NPI Number | 1538580675
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Entity Type | Individual
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Provider Name | GINA ANN THOMPSON OTR
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Gender | Female
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Dates
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Enumeration Date | 12/16/2013
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Last Update Date | 12/16/2013
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Provider Practice Location Address
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Address Line | 2231 US HIGHWAY 12
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City | BALDWIN
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State | WI
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Zip | 54002-3269
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Country | US
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Telephone | 715-684-5020
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Fax | 715-688-4444
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Provider Business Mailing Address
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Address Line | 938 10TH ST N
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City | HUDSON
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State | WI
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Zip | 54016-2384
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Country | US
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Telephone | 651-786-9772
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 284626
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License Number State | WI
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