Provider Demographics
NPI:1316170186
Name:THOMPSON, BOBBI JEAN (PHYSICAL THERAPIST A)
Entity type:Individual
Prefix:MS
First Name:BOBBI
Middle Name:JEAN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9557
Mailing Address - Country:US
Mailing Address - Phone:330-638-0237
Mailing Address - Fax:
Practice Address - Street 1:8055 ADDISON RD
Practice Address - Street 2:
Practice Address - City:MASURY
Practice Address - State:OH
Practice Address - Zip Code:44438-1204
Practice Address - Country:US
Practice Address - Phone:330-448-6964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH225200000X225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant