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General NPI Number Information
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NPI Number | 1881029817
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Entity Type | Individual
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Provider Name | SARAH KAYE THOMPSON ATC, LAT, PES
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Gender | Female
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Dates
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Enumeration Date | 09/10/2013
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 311 N 19TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19103-1102
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Country | US
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Telephone | 845-594-7240
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Fax |
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Provider Business Mailing Address
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Address Line | 7950 HENRY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19128-3010
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Country | US
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Telephone | 845-594-7240
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 152853
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000010360
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License Number State | PA
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