Provider Demographics
NPI:1609348150
Name:THOMPSON, JUSTIN L (ATP)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:L
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
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Mailing Address - Street 1:1111 BARRANCA DR STE 700
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-5006
Mailing Address - Country:US
Mailing Address - Phone:505-452-7731
Mailing Address - Fax:505-321-9245
Practice Address - Street 1:1111 BARRANCA DR STE 700
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-5006
Practice Address - Country:US
Practice Address - Phone:505-452-7731
Practice Address - Fax:505-321-9245
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist