MEDICARE: MS. PATRICIA ANN THOMPSON PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251G0304X	Geriatric Physical Therapist	PT 3483	FL

General Provider Information

NPI Number	:	1255356978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ANN THOMPSON PT

Provider Business Mailing Address
First Line	:	PO BOX 136662
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34713-6662
Country	:	US
Telephone Number	:	352-243-9341
Fax Number	:	352-243-8293

Provider Business Practice Location Address
First Line	:	1050 US HIGHWAY 27
Second Line	:	SUITE #15
City	:	CLERMONT
State	:	FL
Zip	:	34714-7508
Country	:	US
Telephone Number	:	352-243-9341
Fax Number	:	352-243-8293

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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