Provider Demographics
NPI:1881009777
Name:THOMPKINS, SHALOM
Entity Type:Individual
Prefix:
First Name:SHALOM
Middle Name:
Last Name:THOMPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3141
Mailing Address - Country:US
Mailing Address - Phone:269-492-7842
Mailing Address - Fax:269-492-7844
Practice Address - Street 1:925 PARKER AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3141
Practice Address - Country:US
Practice Address - Phone:269-492-7842
Practice Address - Fax:269-492-7844
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner