Provider Demographics
NPI:1225885411
Name:THOMPSON, BILL ANDRAE (KINESIOTHERAPIST)
Entity type:Individual
Prefix:
First Name:BILL
Middle Name:ANDRAE
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:KINESIOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 BAY RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2529
Mailing Address - Country:US
Mailing Address - Phone:810-814-0217
Mailing Address - Fax:
Practice Address - Street 1:4605 BAY RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2529
Practice Address - Country:US
Practice Address - Phone:810-814-0217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist