MEDICARE: ANNA THOMPSON

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	225200000X	Physical Therapy Assistant	001854	WV

General Provider Information

NPI Number	:	1609596808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA THOMPSON

Provider Business Mailing Address
First Line	:	220 PADDLE CREEK RD
Second Line	:
City	:	FORT GAY
State	:	WV
Zip	:	25514-7377
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 PADDLE CREEK RD
Second Line	:
City	:	FORT GAY
State	:	WV
Zip	:	25514-7377
Country	:	US
Telephone Number	:	304-544-3506
Fax Number	:

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

Provider Enumeration Date	:	08/30/2022
Last Update Date	:	08/30/2022

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Directions to “ ANNA THOMPSON ” Practice Location

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