Provider Demographics
NPI:1851417109
Name:THOMPSON, CHRISTY LEE (MPT)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LEE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25546 HIGNUTT RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-2453
Mailing Address - Country:US
Mailing Address - Phone:410-479-3514
Mailing Address - Fax:
Practice Address - Street 1:420 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-3055
Practice Address - Country:US
Practice Address - Phone:410-479-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist