Provider Demographics
NPI:1609291871
Name:THOMPSON, DAVID HARMON (NCTM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:HARMON
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:NCTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22501 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:56011-9266
Mailing Address - Country:US
Mailing Address - Phone:612-237-1676
Mailing Address - Fax:
Practice Address - Street 1:22501 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:MN
Practice Address - Zip Code:56011-9266
Practice Address - Country:US
Practice Address - Phone:612-237-1676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist