Provider Demographics
NPI:1376550780
Name:THOMPSON, AMY E (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2232 W HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-3529
Mailing Address - Country:US
Mailing Address - Phone:918-259-9522
Mailing Address - Fax:918-259-9521
Practice Address - Street 1:2002 12TH AVE NW
Practice Address - Street 2:STE A
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1227
Practice Address - Country:US
Practice Address - Phone:580-226-9235
Practice Address - Fax:580-226-9239
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist