Provider Demographics
NPI:1154605863
Name:THOMPSON, TORI CALEY (PTA)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:CALEY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44480 W HONEYCUTT RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-2903
Mailing Address - Country:US
Mailing Address - Phone:520-582-0142
Mailing Address - Fax:866-672-7115
Practice Address - Street 1:44480 W HONEYCUTT RD
Practice Address - Street 2:SUITE 106
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-2903
Practice Address - Country:US
Practice Address - Phone:520-582-0142
Practice Address - Fax:866-672-7115
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND0781174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist