Provider Demographics
NPI:1588414171
Name:THOMPSON, BRYCE V (RD, LD)
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:V
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 20TH ST N APT 817
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3637
Mailing Address - Country:US
Mailing Address - Phone:478-636-3977
Mailing Address - Fax:
Practice Address - Street 1:201 20TH ST N APT 817
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-3637
Practice Address - Country:US
Practice Address - Phone:478-636-3977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered