MEDICARE: MR. ADAM JAMES THOMPSON LAC, LMT

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	225700000X	Massage Therapist	MT.0018561	CO
2	171100000X	Acupuncturist	ACU.0002087	CO

General Provider Information

NPI Number	:	1770093312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ADAM JAMES THOMPSON LAC, LMT

Provider Business Mailing Address
First Line	:	1055 N LOGAN ST APT 205
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-3033
Country	:	US
Telephone Number	:	612-990-1563
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 16TH ST STE 280
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-4223
Country	:	US
Telephone Number	:	303-371-5280
Fax Number	:

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

Provider Enumeration Date	:	10/10/2017
Last Update Date	:	10/10/2017

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Directions to “ MR. ADAM JAMES THOMPSON LAC, LMT” Practice Location

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