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General NPI Number Information
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NPI Number | 1609935972
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Entity Type | Individual
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Provider Name | LUKE E THOMPSON PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 2919 E MATTHEWS AVE SUITE C
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City | JONESBORO
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State | AR
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Zip | 72401-4499
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Country | US
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Telephone | 870-268-1400
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Fax | 870-268-1405
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Provider Business Mailing Address
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Address Line | 4402 REBEKAH DR
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-9525
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Country | US
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Telephone | 870-530-7571
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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 | PT41762
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License Number State | CA
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