Provider Demographics
NPI:1265001077
Name:THOMPSON RIGGINS, MARTIN FELIPE (ATC)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:FELIPE
Last Name:THOMPSON RIGGINS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W HAMILTON ST APT 317
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-1132
Mailing Address - Country:US
Mailing Address - Phone:717-386-4352
Mailing Address - Fax:
Practice Address - Street 1:950 W HAMILTON ST APT 317
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-1132
Practice Address - Country:US
Practice Address - Phone:717-386-4352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4304854906Medicaid