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General NPI Number Information
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NPI Number | 1790590594
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Entity Type | Organization
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Legal Business Name | THOMPSON REAL ESTATE COMPANY, LLC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 517 NW 4TH ST STE 113
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City | BRAINERD
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State | MN
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Zip | 56401-2985
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Country | US
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Telephone | 218-966-0151
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Fax |
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Provider Business Mailing Address
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Address Line | 24181 435TH ST
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City | MCGREGOR
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State | MN
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Zip | 55760-5698
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Country | US
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Telephone | 218-248-5534
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAMERON ALAN THOMPSON
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Credential | MT
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Telephone | 218-248-5534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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