MEDICARE: STEVEN THOMPSON III PTA

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	PA6571	ME

General Provider Information

NPI Number	:	1912762626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN THOMPSON III PTA

Provider Business Mailing Address
First Line	:	PO BOX 234
Second Line	:
City	:	FRIENDSHIP
State	:	ME
Zip	:	04547
Country	:	US
Telephone Number	:	207-701-7841
Fax Number	:

Provider Business Practice Location Address
First Line	:	91 CAMDEN ST
Second Line	:	SUITE 107
City	:	ROCKLAND
State	:	ME
Zip	:	04841
Country	:	US
Telephone Number	:	207-596-0133
Fax Number	:	207-596-0144

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

Provider Enumeration Date	:	02/21/2024
Last Update Date	:	02/21/2024

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Directions to “ STEVEN THOMPSON III PTA” Practice Location

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