Provider Demographics
NPI:1447065347
Name:THOMPSON, CAMERON ALAN (MT)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:ALAN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 NW 4TH ST STE 113
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-2985
Mailing Address - Country:US
Mailing Address - Phone:218-966-0151
Mailing Address - Fax:
Practice Address - Street 1:517 NW 4TH ST STE 113
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-2985
Practice Address - Country:US
Practice Address - Phone:218-966-0151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist