Provider Demographics
NPI:1285918490
Name:THOMPSON, ROSEMARY (PT)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WALNUT CT
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:CO
Mailing Address - Zip Code:80615-3622
Mailing Address - Country:US
Mailing Address - Phone:970-454-3798
Mailing Address - Fax:970-454-3798
Practice Address - Street 1:40 WALNUT CT
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:CO
Practice Address - Zip Code:80615-3622
Practice Address - Country:US
Practice Address - Phone:970-454-3798
Practice Address - Fax:970-454-3798
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11722251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics