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General NPI Number Information
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NPI Number | 1861677189
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Entity Type | Individual
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Provider Name | KRISTIN LEIGH THOMPSON MED, ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 01/05/2008
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Last Update Date | 01/05/2008
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Provider Practice Location Address
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Address Line | 101A LONG GREEN BLVD
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City | YORKTOWN
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State | VA
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Zip | 23693-4139
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Country | US
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Telephone | 757-886-6480
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Fax |
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Provider Business Mailing Address
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Address Line | 3805 E STEEPLECHASE WAY APT. D
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-7824
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Country | US
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Telephone | 262-705-2646
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0126001186
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License Number State | VA
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